What are the responsibilities and job description for the Medicaid Specialist position at Area Office on Aging of Northwestern Ohio, Inc.?
Job Title: Medicaid Specialist
Employment Type: Full-Time (Non-exempt; salary based on experience and qualifications)
Organization: Area Office on Aging of NW Ohio, Inc.
About Us: The Area Office on Aging is dedicated to helping older adults and people with disabilities remain happy, healthy, and at home in the ten counties we serve in Northwestern Ohio (Defiance, Erie, Fulton, Henry, Lucas, Ottawa, Paulding, Sandusky, Williams, and Wood counties).
If you’re passionate about making a positive impact, consider joining the Area Office on Aging. We provide a warm, professional, and family-oriented work environment where you can truly make a difference. For more details about our services, visit our website at www.areaofficeonaging.com.
Essential Job Functions:
- Complete data entry into the Ohio Integrated Eligibility System (OIES) to facilitate waiver approvals, denials, and closures as appropriate for new enrollees and those who are dis-enrolling.
- Enter initial liability and all liability changes into the ODA-approved documentation system for all enrolled PASSPORT and Assisted Living waiver consumers.
- Enter the PP or AL enrollment into the ODA database when switching from State-funded to full waiver.
- Verify eligibility in the MITS computer system.
- Complete inquiries on the Medicaid status from ADRN, Assessors, Care Managers, and supervisors to assist waiver applicants and enrollees with their Medicaid issues.
- Notify CMs, WSC’s, and Supervisors of Medicaid issues including changes in liability, going on or off My Care Ohio, and loss of Medicaid.
- Monitor and complete a monthly reconciliation of the My Care Ohio HENS report for enrollments and disenrollment. Request status from supervisors when a request is made in HENS if not already enrolled or disenrolled in the Medicaid system via the internal process.
- Submit a copy of the budget screen with the liability to the fiscal department on or before enrollment in PASSPORT, and whenever there is a liability for new enrollment or a change, for all enrolled PP as well as My Care Ohio enrollees who enrolled on PP first.
- Provide other program supports and other duties as assigned by the Supervisor.
- Monitor Provider Gateway for Nursing Facility admissions/discharges to facilitate waiver approval and/or disenrollment. Reach out to facilities as needed.
- Create LTC Details within OIES, tracking outcomes and ensuring Participants receive a Notice of Action for denials of eligibility.
- Complete data entry and monitoring of eligibility of CareSource SRS and OHCW participants.
- Monitor Medicaid eligibility, make monthly contact calls, and assist individuals and/or authorized representatives with the Medicaid process for those pending Medicaid.
- Problem-solving using Medicaid rules effectively.
- Maintain a working knowledge of all Medicaid regulations affecting PASSPORT applicants and participants. Keep informed of Medicaid changes.
- Maintain HIPAA compliance and confidentiality of Participant data. Databases must never be utilized for personal or other non-work-related reasons and would lead to immediate termination if there was a breach in any area mentioned in this section.
- Other duties as assigned by Supervisor, AVP, and Vice President of LTC.
Authority and Relationships:
- This position reports to the Assessor Supervisor and functions with moderate supervision.
- This position has no supervisory authority.
Qualifications:
- Requires an Associate's Degree in Human Services or other 2-year degrees with at least one year of experience in human services.
- Requires proficient computer and data entry skills at 35 words a minute.
- Excellent interpersonal skills and ability to relate to a variety of professional personnel and the community.
- Requires knowledge of Medicaid rules and regulations.
- Good written and oral communication.
- Maintain reliable transportation, insurance, a valid driver's license, and the ability to satisfactorily undergo a Motor Vehicle Record check (MVR) on at least an annual basis.
Special Requirements and Conditions:
- This position shall be terminated if funding is not available for the PASSPORT Program.
- Requires a criminal background check and drug/alcohol screening.
We are an Equal Opportunity Employer and are committed to creating an inclusive environment for all employees. We encourage applications from individuals of all backgrounds, including bilingual and minority candidates.
Weekly Schedule:
AOoA is open Monday – Friday from 8:00 am – 5:30 pm.
Benefits:
- Health, Dental & Vision Insurance
- Life Insurance
- 403(B) retirement plans
- Generous Paid Time off
- Mileage Reimbursement at the IRS rate
- Flexible Schedule – Weekends and Holidays off!
- Travel Expenses
- Training/Tuition Reimbursement
Work Location: Toledo, Ohio 43609
Submit resumes to: jobs@areaofficeonaging.com
Human Resources
Area Office on Aging of NW Ohio, Inc.
2155 Arlington Avenue
Toledo, Ohio 43609
Area Office on Aging of NW Ohio, Inc.
2155 Arlington Avenue
Toledo, Ohio 43609
