Tennessee Medicaid Eligibility Specialist

Job Description

Job Description

Medicaid Eligibility Specialist - Statewide Hybrid Position

Prestige Healthcare invites you to apply and be part of a team that truly values your contribution. We offer competitive wages and are committed to fostering a workplace where growth, teamwork, and patient-centered care are at the forefront. At the end of each day, knowing that you’ve made a meaningful impact in the lives of our residents will be your greatest reward.

Coverage: Prestige Healthcare / Tennessee Facility Locations

Why Choose Prestige Healthcare?

• Employee Focus : We foster a positive culture where employees feel valued, trusted, and have opportunities for growth.
• Employee Recognition: Regular acknowledgement and celebration of individual and team achievements.
• Career Development: Opportunities for learning, training, and advancement to help you grow professionally.

Key Benefit Package Options?

• Medical Benefits : Affordable medical insurance options through Anthem Blue Cross Blue Shield.
• Additional Healthcare Benefits : Dental, vision, and prescription drug insurance options via leading insurance providers.
• Flexible Pay Options: Get paid daily, weekly, or bi-weekly through UKG Wallet.
• Benefits Concierge : Internal company assistance in understanding and utilizing your benefit options.
• Pet Insurance : Three options available
• Education Assistance : Tuition reimbursement and student loan repayment options.
• Retirement Savings with 401K.
• HSA and FSA options
• Unlimited Referral Bonuses .

Start a rewarding and stable career with Prestige Healthcare today!

Essential Duties and Responsibilities:

• Train and Mentor facility staff and ensure that facilities efficiently coordinate the timely
• completion and gathering of documentation for Medical Assistance applications.
• Cultivate positive relationships with Medical Assistance and MCO caseworkers and ensure that all additional requested documentation is submitted in support of the Resident’s application process.
• This includes the proactive identification of the resident’s need for guardianship or conservatorship services to secure documentation for the Medicaid application process.
• Serve as Liaison between assigned facility teams, responsible party, legal counsel, MCO’s and County Assistance Office.
• Keeps up to date on Payor, Pre-Admission Assessment and authorization requirements and Regulatory changes relating to eligibility
• Anticipate potential eligibility red flags during the application process and mitigate by communicating with Business Office and Operations management to ensure proactive approach to removing barriers.
• Coordinates the gathering and submission of documentation in support of case management efforts in the authorization for services. As well as supporting documentation to support billing denials and requests for additional data.
• Participate in Regional and Corporate meetings as required.
• Recognize and perform other duties which need to be performed or as assigned.