Job Details

Medicaid Pending Specialist

You will be responsible for obtaining the Medicaid Pending information from responsible parties to include timely follow up until completion. Provides ongoing support to the Senior Medicaid Advocate to ensure an approval for admission can be determined accurately to obtain Medicaid Eligibility.

Principal Responsibilities:

• Assist with the Medicaid Pending process by contacting the responsible party to request backup information for the items provided on the Medicaid Questionnaire.
• Have communication with the residents and/or family members regarding the application process and supporting documentation needed.
• Maintain tracking system for all assigned Medicaid Pending referrals to ensure timely completion.
• Detailed email communication within the referral group attaching required information.
• Report any delays or barriers to the Senior Medicaid Advocate.
• Report weekly to the Senior Medicaid Advocate and VP of Revenue Cycle Management of any outstanding items which assistance may be required and status of referrals.
• Pick up the PO box mail and distribute.
• Ensure compliance with all State laws in relation to your position.
• Adherence to the Organization's Compliance Plan and Code of Ethics.
• May occasionally assist other departments within the Accounts Receivable department.
• Other duties, responsibilities and activities may change or assigned at any time with or without notice.
• Human Resource Management Responsibility:
• Follows Human Resources practices at each facility to ensure compliance with employment laws and company policies, and to ensure practices that maintain high morale and staff retention to include effective communication, prompt problem resolution, proactive supervisory practices, and maintaining a proactive work environment.
• Conduct continuing education programs and special in-service training to direct reports and special in-service for all staff; Maintains frequent, daily, informal interaction and provides positive feedback to staff while they are working; Maintains open door policy in dealing with staff.
• Follows, interprets, and enforces corporate personnel policies.
• Communicates clearly and responsively on issues arising in the facility to decision makers who are outside of the facility and follows-up to minimize negative impact of issues.
• Participates in the interdepartmental and departmental meetings, where appropriate, to maintain liaison between the leadership and facility personnel.
• Manages all region's internal relationships according to the company policies, procedures, directives, etc.
• Attends and participates in all Human Resources Workshop.

Qualifications:

• Experience in the application/renewal process for Medicaid in LTC facilities
• Experience with TMHP and SimpleLTC portals preferred
• Proficient computer skills
• Well organized and able to multitask
• Attention to detail
• Ability to travel, which includes a valid driver's license and automobile insurance