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Medicaid Specialist

syracuse, ny • Posted 1 weeks ago
Onsite Full Time Community and Social Service Occupations
Join Our Team as a Full Time Medicaid Specialist!

At St. Camillus, we're centered on celebrating our employees! Our team is what makes St. Camillus an amazing place to work.

We are currently seeking a Full Time Medicaid Specialist to join our Patient Financial Services Team!

Responsibilities:

This position will work with the staff in the Patient Financial Services (PFS) and Finance departments, as well as with residents/family members, including, but not limited to, reviewing insurance coverage with families to determine financial liability and/or need for Medicaid; determining estimated Net Available Monthly Income (NAMI); completing, monitoring and ensuring timely submission of Medicaid applications and recertification's; maintaining knowledge of third party billing regulations; and assisting with the day-to-day billing functions as needed.

  • Must be knowledgeable of the most current Medicaid regulations and the Medicaid application process.
  • Responsible for reviewing insurance coverage with families as needed throughout their stay, detailing any potential financial liability and determining whether/when Medicaid will be needed.
  • Responsible for estimating residents' NAMI and ensuring NAMI income comes to the facility.
  • Responsible for the completion of residents' Medicaid applications and annual recertification's within specific timeframes.
  • Must track the Medicaid application submission deadlines and status and have continual communication with the local DSS office, St. Camillus staff, and our residents/their family members to ensure timely approval and increased cash flow.
  • Must ensure all required documentation is obtained from the family or work with their financial institution, etc. to obtain the information on their behalf.
  • Responsible for completing and submitting all requested Medicaid forms and documents such as LDSS 3559s, Nursing Home Account Sheets, PRIs, etc.
  • Maintain accurate records of member's eligibility status, recertification dates and MLTC provider.
  • Must be knowledgeable on general skilled nursing facility payers and billing procedures.
  • Utilizes various financial reports to follow private accounts that may need Medicaid.
  • Once Medicaid applications are approved, enter the information into the billing system for processing.
  • Reports all Medicaid application issues to the PFS Manager, Director of Finance and VP of Finance on a routine basis.
  • Provide written referral and backup documentation on Medicaid cases requiring attorney involvement.
  • Responsible for assisting with billing tasks as needed.
  • Responsible for assisting with any financial audits initiated by outside agencies, including but not limited to the Office of the Medicaid Inspector General (OMIG) and Social Security.
  • Support department Manager, Director of Finance, and VP of Finance with all required tasks.
  • Responsible for employee injury prevention, follows safety rules and addresses safety issues with supervisor.
  • All other duties as assigned by supervisor.

Qualifications:

  • Associate's Degree
  • Experience in Medicaid Eligibility and/or Skilled Nursing Facility Medicaid billing.
  • Strong Microsoft office experience (Word and Excel)
  • Strong verbal, written, computer and leadership skills are required.
  • Must be a team player and be able to build strong relationships with our residents and their families.
  • Must be able to work independently managing multiple projects at once.

Employee Benefits:

  • Generous Paid Time Off!
  • Affordable Health/Dental/Vision Plans
  • Company Funded Life Insurance and Health Reimbursement Account
  • Retirement Plan
  • On the Centro Bus Line
  • Free parking
  • On-site cafeteria

Why Work At St. Camillus?

Our Mission: St. Camillus is a non-denominational, not-for-profit organization dedicated to caring for life through a broad range of health care services.

Our Vision: To be the provider of choice for compassionate and innovative care.

For more information about St. Camillus and Integrity Home Care Services visit our website.

EOE/Affirmative Action Employer

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