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This position is responsible for directing, managing, and coordinating all activities of: Medicaid Eligibility Quality Control, Payment Error Rate Measurement, Medicaid Eligibility Quality Assurance Monitoring, Investigations into suspected Medicaid Member Fraud, Waste, and Abuse, and confirming the Wyoming Medicaid and KidCare Childrens Health Insurance Program (CHIP) are administered in compliance with all federal and state eligibility rules, regulations, policies, and procedures.
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The Eligibility Specialist is responsible for assisting hospital patients with the completion of the application process for Medicaid. The Eligibility Specialist not only acts as an advocate for the patient, but also serves as a liaison to other Team members and to client hospital in a collaborative effort to facilitate eligibility coverage for incurred medical expenses.
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Determines eligibility for ADAP by verifying lab results in HMS and Medicaid eligibility status in CHC. Provides referrals to clients who does not qualify for ADAP to community partners, e.g. HealthCare District, FoundCare, AIDS Healthcare Foundation (AHF), or Compass.
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The Enrollment Coordinator must ensure that all assignments are completed accurately and in a timely manner in accordance with NYSDOH Medicaid guidelines, MLTC provider regulations, and agency policies and procedures.
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Programs we administer include Supplemental Nutrition Assistance Program (SNAP), Long Term Care (LTC) services, Temporary Assistance to Needy Families (TANF), Employment Related Day Care (ERDC), Domestic Violence services and various Medicaid (Health insurance) programs.
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Work involves frequent contact with case managers in Community Care Services Eligibility (CCSE), individuals enrolled in or applying for 1915(c) waiver services, service providers, LTSS MCOs, relocation specialists, nursing facility staff, the public, Health and Human Services Commission, Managed Care Compliance and Operations, Health Plan Management, and Medicaid for the Elderly and People with Disabilities (MEPD) staff.
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Facilitate the ongoing eligibility of consumers for services including medical eligibility, knowledge of private insurance benefits, Social Security, Medicaid, Medicare, Kansas Brain Injury waiver, and other funding options.
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Health services research, such as healthcare quality, Medicaid eligibility, Medicaid/Medicare claims, health disparities, or chronic diseases. Concierge prescription delivery on the main campus when using UAMS pharmacy.
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Participate in regular after-hours crisis coverage rotationCarry cases as primary or assisting clinician as assignedUtilization trackingTrack and record Verification of Medicaid eligibility for all children/youth referred.
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Service coordinators monitor and ensure that assigned participants maintain Medicaid eligibility. Participants living in private community homes are Medicaid-eligible through PA Health and Wellness or AmeriHealth Caritas.
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We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. In conjunction with the Medicaid Eligibility Staff visit all uninsured patients in-house.
$17.36 - $26.05 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Assist patients with payment arrangements and in co-ordination with the Medicaid Eligibility Staff assists patient with financial applications. Utilizes eligibility systems, on-line websites or phone calls to determine insurance benefits and precertification requirements.
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Note: Eligibility for benefits may vary by location. HCA Healthcare Co-Founder. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing.
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Additionally, the Eligibility Specialist is responsible for handling inbound calls from Medicaid, SNAP, and TANF applicants, recipients, and other members of the community. The Eligibility Specialist is responsible for processing applications and completing case maintenance activities such as changes to cases in the State eligibility system and ensuring that client service issues are resolved in a timely manner and in accordance with FSSA policies and procedures.
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Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. The Enrollment Coordinator is expected to: utilize various automated systems, such as: MCO, MP, ePACES, and the Response File Reader.
$38,545.53 - $48,181.92 a yearPart-timeExpandApply NowActive JobUpdated Today
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