Eligibility & Financial Redetermination Rep

Job Description

Job Description

Responsibilities

The  Eligibility & Financial Redetermination Representative is responsible for assisting participants and their families/ caretaker(s) in the annual redetermination process for Medicaid which includes the process of obtaining documentation, providing participants with resources and assisting in necessary paperwork/documentation of all necessary forms. 

• Completes all re-determinations for InnovAge PACE participants assigned 30 days before case due date. Monitors the Medicaid aging report and works to clear aged items in a timely manner.
• Communicates the policies and procedures of Long Term Medicaid, Spousal Impoverishment, and Trusts to participants in a way that is easily understood by participants, families and caregiver(s).
• Performs home visits and/or Day Center visits to complete all Medicaid redeterminations within required time frames in a manner that is most convenient and efficient for the participant.
• Assists participants, families and caretaker(s) in completing necessary paperwork needed for Medicaid re-determination including collaborating with county government technicians to assess additional documentation needed.
• Documents work and outcomes in the Participant Tracking System Record of Contact Notes and in the department tracking model.
• Organizes case load and working area in an efficient manner that allows information to be accessed when not available.
• Completes disenrollment forms for HMO’s and forward to supervisor in a timely manner.
• Processes participant/Intake/social worker housing forms and completes new supporting housing forms for all RV’s if there is a differential in income.

REQUIRED

• Current knowledge of the Medicaid system/benefits in addition to community resources that are available to seniors and their families.
• High School diploma or GED required.
• Requires a valid state issued driver’s license, personal transportation, good driving record and auto insurance as required by law

PREFERRED

• Bi-lingual