November 7, 2024

Journey

Charleston

FULL TIME

Medicaid Eligibility Specialist

Position Summary: Medicaid Specialist supports our multi-facility healthcare operations and manages the complexities of the Medicaid system, particularly in relation to qualifying for long-term Medicaid benefits. The Medicaid Specialist is crucial in ensuring that our patients receive the appropriate services and support to navigate their Medicaid options.
Essential Job Functions:
· Eligibility Determination: Assess and verify Medicaid eligibility for patients across multiple facilities, ensuring compliance with state and federal regulations.
· Application Assistance: Guide patients and their families through the Medicaid application process, including gathering necessary documentation and completing forms.
· Long-Term Care Planning: Educate patients on long-term Medicaid eligibility criteria and assist in planning for long-term care needs.
· Policy Interpretation: Stay updated on Medicaid policies, regulations, and changes at the state and federal levels to provide accurate information and guidance.
· Interdepartmental Collaboration: Work closely with social workers, case managers, and financial counselors to coordinate care and streamline processes.
· Patient Advocacy: Act as a liaison between patients and Medicaid services, advocating for patients' needs and addressing any issues that arise.
· Training and Support: Provide training and support to facility staff on Medicaid-related processes and changes in policies.
· Data Management: Maintain accurate records of patient interactions and Medicaid applications, ensuring confidentiality and compliance with HIPAA regulations.
· Other duties as assigned within scope of practice and abilities
Education, experience, and other required qualifications:
· Education: Bachelor’s degree in social work, healthcare administration, or a related field preferred, but not required.
· Experience: Minimum of 2-3 years’ experience working with Medicaid, preferably in a healthcare or long-term care setting.
· Knowledge: Strong understanding of Medicaid eligibility requirements, long-term care services, and relevant state and federal laws.
· Excellent communication, interpersonal, and organizational skills; ability to handle sensitive information with discretion.
· Technical Proficiency: Proficient in using electronic health/medical records (EMR/EHR) systems and Microsoft Office Suite.
· Certification in Medicaid eligibility or related fields.
· Experience working with multi-facility operations.
Personal Skills and Traits Desired/Physical Requirements/Working Conditions
· Works beyond normal working hours and on weekends, holidays when necessary.
· Position may require some travel – i.e. corporate meetings, training, facility visits, etc.
Job Type: Full-time
Benefits: