Medicaid Specialist

Position Summary:

Medicaid Specialist will be responsible for working on Medicaid Pending Applications and Renewals to ensure financial eligibility for the dates of service needed to secure valid Medicaid payer status for the facility.

 

Responsibilities:

 ·         Medical Assistance Applications & Renewals including processing of all appropriate forms applicable to the State per GA Medicaid (GA Department of Family and Children Services) Policy and Procedures.

·         Meet with the families/responsible party, by GA Medicaid Policy and Procedures guidelines, and determine and obtain paperwork needed to complete the Medicaid application.

·         Monitor and document the progress of the pending Medicaid cases and Renewals in the EMR A/R Collection Module per the facility’s policy and procedures.

·         Follow up with the county Medicaid office on status of cases per GA Medicaid Policy & Procedures.

·         Communicate timely to BOM, Administrator, and RFA of any potential problem cases or non­compliance by family/responsible parties per GA Medicaid Policy & Procedures.

·         Participate in Medicaid Pending AR Meetings to review all Medicaid Pending cases (as scheduled).

·         Upload appropriate documentation to the facility’s EMR Miscellaneous Tab and to the GA Medicaid portal.

·         Responds to case discontinuation and/ or denials by determining the action required which may include Appeal, Reapplication or Acceptance.

·         Performs other duties or projects as assigned by Business Office Manager.

 Skills:

 Must have strong organizational skills with a good sense of detail. Good verbal and written communication skills. 

 Experience: 

Medicaid and skilled nursing facility background preferred.

 Education: 

High School Diploma or GED required.

 

For more Information regarding the HB531 Florida Agency for Health Care Administration, please visit: https://info.flclearinghouse.com