Medicaid Specialist

Consulate Health Care
Tallahassee, Florida
Not Specified
Feb 17, 2017
Feb 20, 2017
Job Type
Not Specified
Career Level
Not Specified
Job Overview:Join Consulate Health Care's Team of Extraordinary Heroes! Anextraordinaryopportunity to start 2017 with one of the nations top Long Term Care, Skilled Nursing health care providersin our Panhandle, Florida Region! As one of America s top leading providers of medical services and rehabilitation for elderly patients in communities across the nation, Consulate Health Care provides the highest standard of services for short-term and long-term care needs. Even as we ve grown to become the sixth-largest provider in the nation and the largest in the Sunshine State, it s the little things we do while fulfilling our mission statement of Providing Service with Our Hearts and Hands that really make the difference. A position with Consulate Health Care means more than just a paycheck. We believe in creating a positive environment that reinforces your efforts to succeed and supports your long-term career development. We offer the opportunity to work with large corporation, but with the benefit of a small company feel! As a RegionalMedicaid Specialist, the primary purpose of your job position is to assist facility staff with the Medicaid Application process. Responsible for educating in regard to the process, validating the process is efficient once implemented and developing plans for reducing days in AR related to Pending Medicaid balances. This position is a non-supervisory function. This job description does not list all the duties of the job. You may be asked by supervisors or managers to perform other duties. You will be evaluated in part based upon your performance of the tasks listed in this job description. The employer has the right to revise this job description at any time, for any reason. Duties/Responsibilities: Responsible for the oversight and success of the pending Medicaid application process for a group of assigned skilled nursing facilities. Educate Care Center staff regarding the pending Medicaid application process, including identification of all pending/recertification files, incomplete 3008 forms, timely completion of PASRR II assessments, citizenship issues, unsigned documents, missing financial information, evaluation of income&asset levels for potential admissions and residents already admitted. Provide guidance to Care Center staff in determining appropriate actions needed to resolve applicant status if ineligible. Assess high risk direct admit No Payer - Medicaid Pending with Executive Directors and Admission Directors through the pre-admission screening process. Assist with all levels of Disability application processes including assistance w/web based application and phone interviews. Ensure effective processes are in place at the Care Centers for processing Pending Medicaid application, recertification documentation and tracking the status of open pending Medicaid applications Troubleshoot previously denied files including obtaining previously unattained documentation, including advising on appeal processes and time restraints attached to appeal limits per state protocol Communicate with government agencies when needed Attend State sponsored seminars/trainings associated with the Skilled Nursing Facility Pending Medicaid processes; communicate and educate at the Care Center level Stay abreast of State updates to Skilled Nursing Pending Medicaid updates-communicate and educate to the Care Center level Determine and discuss the need for Medicaid service companies/attorney offices to address income levels, asset levels, Qualified Income Trust needs and Guardianship needs. Recommend to Care Centers when a 30 day notice should be considered to any resident or designated representative that non compliance with submission of documentation needed to complete the Medicaid application process as required by Department of Children and Families, Social Security Administration and other regulatory agencies. Identify underlying issues with Medicaid Pending policies and procedures on a Care Center level. Develop and implement training on procedures and provide support to Medicaid designated staff to streamline the application to eligibility process. Determining the best course of action to resolve issues in both the pending Medicaid files as well as recertification issues. Analyze the status of all Medicaid pending account balances and develop strategies for resolution of outstanding balances Provide status reports and develop action plans to resolve outstanding Medicaid pending balances. Perform all other duties, as assigned. Position Requirements: Must have a minimum of 3 years experience as one of the following:1)Skilled Nursing Medicaid billing&eligibility screeningor2)Social Worker with Skilled Nursing Medicaid eligibility processing experienceor3)Other role serving as a Skilled Nursing Medicaid eligibility liaison with Skilled Nursing Medicaid eligibility processing experience. Must possess, as a minimum, a high school diploma or its equivalent, two-year degree preferred. Must have experience with Excel and Microsoft Office programs. Must possess knowledge of and demonstrated skill with the pertinent billing software. Company Overview:Consulate Health Care is excited to introduce our New Work Life Balance Program!! Consulate Health Care recognizes the significant time demands on select positions and now offers a Work Life Balance Program (WLBP), a favorable benefit for both the employee and company allowing flexibility in time off. The Work Life Balance Program is not your typical accrual based program, but is consideredUnlimitedtime off for the purposes of vacation and absences related to illness/injury. Our WLBP isavailable to you effective immediately upon start!No waiting periods! You may take up to two (2) consecutive weeks at any time, with prior approval from your supervisor. In addition, employees covered under WLBP will automatically be paid for the six (6 ) company recognized holidays: New Year s Day Memorial Day Independence Day Labor Day Thanksgiving Day Christmas Day We recognize the importance of your position and as such, we ve gone through great lengths to provide you with a superior work/life balance program, which is not easily matched or even available in the long term care sector. Where Will Compassion Take You? At Consulate Health Care, we're looking for talented, compassionate and hard-working individuals who are eager to serve others. Our team members go above and beyond to give our residents and patients the care they deserve so you'll find that every day with Consulate Health Care offers new and exciting opportunities to learn and grow. Compassionate hearts and passionate dedicationthese two qualities shine in our team members and provide the foundation for our mission ofProviding Service With Our Hearts and Hands. The compassion you'll show to residents, patients and their families is the lifeline of our business, while relationships with your peers and coworkers will strengthen our vibrant, diverse community. Consulate Health Care is one of the nation's leading providers of Senior healthcare services, specializing in post-acute care. Operating nationwide, we offer services ranging from short-term transitional care to Alzheimer s and dementia care. 24-hour skilled nursing care Comprehensive post-acute care Physical, Occupational and Speech therapies "Your Journey Home"short-term rehab program Alzheimer's and dementia care Care for medically-complex patients