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Medicaid Planning Specialist

10010109 Global Healthcare Fiscal Services LLC
Howell, NJ Full Time
POSTED ON 12/20/2024
AVAILABLE BEFORE 2/20/2025

Job Purpose

Collaborate with the facility business office to ensure that all facility residents have a billable payer source and that the facility can collect all monies due.

Duties & Responsibilities

1. Verify payor source for all residents to ensure that payment will be forthcoming

- Enter daily census received from facility into Veripay

- Gather all relevant New Resident Information and document in Veripay

- Research all available systems to confirm resident source of payment

- Confirm initial/updated authorizations and co-pays

- Ensure timely submission of levels of care and relevant forms

2. Facilitate Medicaid Pending application process

- Obtain asset and income information

- Validate resident eligibility

- Review Medicaid application provided by facility

- Follow through on application process until approval obtained

3. Communicate with biller to ensure coordinated efforts on activities

- Instruct biller of changes to payers and billing information

- Investigate and resolve issues to ensure a continuous and billable payer source

- Coordinate collection of due patient liability

4. Collaborate with facility administration to obtain all payment due

- Coordinate weekly meetings with BOM to ensure continuous payor source for every resident

- Coordinate collection of continuous due patient liability

5. Review reports to monitor activity

- Maintain office system to support tracking of efforts (documentation of progress in Veripay)

- Prepare agings to keep supervisor informed of all outstanding balances

6. Other duties as assigned

Qualifications

A successful individual in this role will:

- Preferably possess a familiarity with Medicare/Medicaid processes.

Specific requirements:

- Able to prioritize and meet deadlines

- Attentive to detail

- Possesses proactive nature

- Able to multi-task

- Able to rapidly learn and apply knowledge

- Effective and courteous communication and listening skills

- Able to remain calm in stressful situations

- Possesses excellent customer service skills

- Organization skills

- Assertive nature

- Possesses basic computer skills such as Microsoft Office applications

Compensation Range:

$18.00-$39.00

Salary : $18 - $39

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