Demo

Medicaid Specialist Long Term Care

Adams County CO
Westminster, CO Full Time
POSTED ON 1/13/2025
AVAILABLE BEFORE 4/7/2025

Salary : $47,774.99 - $70,898.08 Annually

Location : Westminster, CO

Job Type : Regular Full-time

Remote Employment : Flexible / Hybrid

Job Number : 06862

Department : Human Services

Opening Date : 12 / 30 / 2024

Closing Date : 1 / 20 / 2025 4 : 30 PM Mountain

Our Mission : At Adams County, our team members engage in top-notch opportunities to grow and expand their impact. We cultivate an inclusive and innovative culture where diversity matters! Diversity, Equity & Inclusion (DEI) is a core cultural competency at Adams County, and we actively seek and welcome applicants that bring diverse experiences and value inclusion.

Cultural Competencies / EEO : Adams County is an equal opportunity employer. We strive to have a workforce that reflects the community we serve. No person is unlawfully excluded from employment opportunities based on race, color, national origin, ancestry, religion, creed, sex, sexual orientation, gender expression, gender identity, age, disability, genetic information, veteran status,marital status or any other legally protected characteristic.

Position classification : Hybrid Job duties and expectations allow for onsite and remote work scheduled every week. Employees in this classification are regularly scheduled onsite one (1) to four (4) days per week based on the County needs and as determined by Department Director. Hybrid classified roles can be onsite more than the set minimum based on employee preference.

What Success Looks Like In This Job

This series of positions determines eligibility for Health First Colorado (formerly Medicaid), including Long Term Care and CHP . This position works under a contract with a specified community partner. This series of positions may be required to be onsite at various community partner locations.

  • Compensation is based on experience and qualifications

Examples of Duties for Success

  • Examines applications to determine applicants / participants income, resources, household composition and employment status to assess their eligibility for medical assistance.
  • Reviews applications for accuracy and completeness and makes requests for information regarding incomplete forms and missing documentation. Verifies required information by appropriate methods : e.g., phone calls to employers; applicants; computer database inquiries (interfaces); statistical reports from the State and / or change or status reports turned in by clients to determine program eligibility.
  • Explains program eligibility requirements to applicants, including all rules and regulations, his / her rights and responsibilities, available benefit dates, reason for approval or denial and the right to appeal.
  • Interface daily with statewide computer system requiring accurate and complete data entry of information. Interprets and evaluates computer generated data to determine application to individual case processing for approvals, changes, denials, and discontinuations.
  • Utilizes computer daily for inquiry and data entry for preparation of complex correspondence, spreadsheet development and record maintenance and research. Maintain client records within the Colorado Benefit Management System (CBMS) and electronic case file in the Department's electronic document management system. Document all actions taken on applications and cases within CBMS.
  • Completes monthly reports that are instrumental in discovering discrepancies that could affect participant's eligibility.
  • Works closely with contracted community partner staff to share relevant information with the support of the supervisor.
  • Participates along with supervisor in the dispute resolution process with applicants / participants when requested. Prepares evidence, attends, and testifies in state level hearings on applicant / participant appeals.
  • Partners with supervisory support with service providers and other agencies to achieve positive outcomes for clients.
  • Performs other related duties and responsibilities as required.

    Qualifications for Success

    To be successful, our ideal candidate should have the following knowledge, skills, and abilities

  • Knowledge of medical public assistance programs, as applicable.
  • Knowledge of CBMS.
  • Apply basic math and read, interpret, and apply rules and regulations.
  • Communicates clearly and concisely, both orally and in writing.
  • Differentiate between relevant and non-relevant information when making eligibility decisions.
  • Input data accurately and detect errors / make corrections.
  • Skills related to customer service.
  • Ability to establish, maintain, and foster positive and harmonious working relationships with those contacted in the course of work.
  • More Qualifications for Success

    Med Contracts Specialist I : Responsible for processing Medicaid benefits and coordination with a community partner with supervisory support.

  • Experience : This position requires at least one year experience in an entry level position determining eligibility in CBMS for Medicaid.
  • Education and Training (All Levels) :
  • High School Diploma or GED equivalent.
  • Satisfactory completion of an Associate's or bachelor's degree in business, behavioral science, or another appropriately related field may substitute for experience on a year for year basis.
  • License or Certificate (All Levels) : None.
  • Background Check (All Levels) : Must pass a criminal background check.
  • Other (All Levels) :
  • Bilingual applicants are preferred.
  • Ability to work in a standard office environment.
  • Med Contracts Specialist II : Responsible for processing Medicaid benefits and independently training and coordinating with a community partner.
  • Experience : This position requires at least two years' experience in a position determining eligibility in CBMS for Medicaid.

  • Education and Training (All Levels) :
  • License or Certificate (All Levels) : None.
  • Background Check (All Levels) : Must pass a criminal background check.
  • Other (All Levels) :
  • Ability to work in a standard office environment.

    Adams County complies with Colorado's Job Application Fairness Act ("JAFA"). JAFA prohibits employers from asking individuals to disclose their age, date of birth, or dates of school attendance or graduation on an initial employment application. However, additional application materials such as certifications and transcripts containing this information may be required for certain positions; if such additional materials are requested, applicants may redact information that identifies the applicant's age, date of birth, or dates or attendance or graduation.

    Adams County provides a comprehensive benefits package to employees that goes above and beyond what is offered at most organizations.

    Click to watch our video about why Adams County is an Employer of Choice!

    Benefits You Expect :

  • AFLAC Supplemental Medical Insurance
  • Basic Term Life & Optional Term Life Insurance
  • Deferred Compensation Plan
  • Dental / Vision / Medical Plans
  • Generous Vacation / Sick leave
  • Long-Term Disability
  • Retirement Plan
  • Short-Term Disability
  • Plus some you might not expect :

  • Employee Assistance Program
  • Employee Fitness Center
  • Employee Health Clinics
  • Flexible Work Schedules
  • Recreation Center Discounts
  • Training & Tuition Reimbursement Programs
  • Wellness programs
  • Lactation friendly certified workplace
  • Please be aware that your cover letter and resume will not be accessed in the initial screening process, so you must complete your application and supplemental questions with as much detail as possible. Any personally identifiable information (PII) such as name and address will be redacted from applications that meet the minimum screening requirements and are forwarded to the hiring manager. If the hiring manager selects you to advance in the hiring process, your cover letter and resume will then be accessible to the hiring team. Information provided on the application is used to determine if a candidate meets minimum qualifications. Only information provided at the time of the application being completed will be considered and additional information that is not listed on the application will not be considered when deciding if a candidate meets or does not meet the qualifications. Applicants are STRONGLY encouraged to include all information and details on their application. I understand and agree that only information provided at the time of my application will be used to determine if I meet the minimum requirements for this position.

  • Yes, I understand and agree
  • Yes, I understand but disagree.
  • Please select how you meet the minimum qualifications.

  • At least two years' experience in a position determining eligibility in CBMS for Medicaid AND a High School Diploma or GED equivalent.
  • At least one year experience in an entry level position determining eligibility in CBMS for Medicaid AND a High School Diploma or GED equivalent.
  • No experience, AND an Associate's Degree or higher in business, behavioral science, or another appropriately related field.
  • None of the above.
  • Do you have 1 year experience determining eligibility for Long-Term Care cases using Colorado Benefit Management System (CBMS)?

    Required Question

    Salary : $47,775 - $70,898

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