Demo

Lead Medical Specialist

Beecan Health
Denver, CO Full Time
POSTED ON 2/2/2025
AVAILABLE BEFORE 5/2/2025

Job Description

Job Description

The Lead Medicaid Specialist is responsible for the overall management of the financial eligibility process for State Medicaid. Communicate with facility personnel, families, and residents to obtain and expedite Medicaid eligibility and payment.

DUTIES AND RESPONSIBILITIES

  • Managed the Medicaid pending process with facilities to obtain approvals timely.
  • Train facilities and other interdisciplinary team members on the Medicaid Pending process.
  • Follow up with County and other state workers regarding applications and global issues.
  • Represent the company at all State Medicaid Related meetings and calls.
  • As needed, review Medicaid applications / redeterminations for appropriate documentation and accuracy.
  • Meet with facility staff and residents / family members as needed.
  • Review and update as needed Medicaid Pending Logs and summary logs for assigned facilities.
  • On-call availability to assist with questions or problems.
  • Communicate with the VP of Revenue Cycle, Director of Revenue Cycle and Revenue Cycle Managers regarding facility needs, concerns, and financial personnel.
  • Suggest enhancements to policies or procedures that are relevant and unique to facilities.
  • Participate in AR reviews, trainings and strategy meetings.
  • Travel to facilities on an as needed basis.
  • Performs other related duties as required.

KNOWLEDGE, SKILLS, ABILITIES & QUALIFICATIONS

  • Must possess, as a minimum, an associate's degree in accounting or business administration (or related field) from an accredited college or university. An equivalent combination of education, training, and experience may substitute for education requirements.
  • Minimum of 3 year of experience with CO Medicaid application processes.
  • Knowledge & Understanding of Medicaid Long Term Care program eligibility as well as application / redetermination timelines and regulations.
  • Ability to multitask and work in a fast-paced environment.
  • Strong organizational skills and attention to detail required to succeed in the role.
  • Commitment to the Beecan mission to consistently deliver high quality, person-centered care with dignity, respect, compassion, and integrity, and to enrich every life we touch. Embracing Beecan values of care & compassion, community, honesty & integrity, teamwork, innovation, and safety.
  • Ability to represent the Company and interact with others in an ethical and professional manner, and to maintain accountability.
  • Must have excellent verbal and written communication skills, both one-on-one and in a group, and ability to listen and respond to questions effectively.
  • Must have excellent time management skills with a proven ability to prioritize and meet deadlines.
  • Ability to maintain confidentiality, and to exercise discretion and independent judgment to make logical, practical decisions.
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