Medicaid Eligibility & Enrollment Specialist

Job Purpose The Medicaid Coordinator is part of a team that works to complete the Medicaid application process for patients of our hospital clients for both in-house and discharged patients. The Medicaid Coordinator assists in gathering and processing information from patients. They will follow through expeditiously to assist patients in obtaining Medicaid, which ensures prompt payment to our client hospitals. Duties and Responsibilities Call patients and screen for Medicaid eligibility on cases referred by client hospital over the phone Enroll patients in health insurance coverage via Marketplace or by completing the paper application package to submit to HRA/Local Department of Services Review, validate and process confidential information Research and verify patient contact information using search engines and hospital computer systems Research and resolve Medicaid-related issues Send various automated letters to patients from the Firm’s database Retrieve information from hospital databases Send the Medicaid Clerk a request for third party information and review upon receipt Verify insurance Update the Firm’s internal database with all work done on an account (actions taken to comminicate with patients, code, account) Track application status via the Marketplace and/or call LDSS/HRA for status Keep track of the status of denied applications throughout the Fair Hearing process Prepare and review reports on open accounts using Microsoft Excel Schedule and coordinate meetings with patients Manage calendars Respond to requests for additional documents from Market Place/Department of Social Services Other duties as assigned Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards Understand and comply with Information Security and HIPAA policies and procedures at all times Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties M-F 7a-330p for 2 weeks & Tues-Sat 7a-330p for 2 weeks Qualifications High School Diploma or equivalent is required Bilingual English/Spanish is required Experience with ePACES and LexisNexis is a plus Experience in the field of healthcare or insurance plans is a plus Strong investigatory and researching skills Must have had administrative experience Proficiency in Microsoft Office Suite Ability to use the internet and learn databases Strong interpersonal skills, ability to communicate well at all levels of the organization Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses High level of integrity and dependability with a strong sense of urgency and results oriented Excellent written and verbal communication skills required Working Conditions Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes. Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear. Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress. Work Environment: The noise level in the work environment is usually minimal. Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law. #J-18808-Ljbffr Med--metrix