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Medicaid Pending Representative

Care Network
Valley Stream, NY Full Time
POSTED ON 1/22/2025
AVAILABLE BEFORE 4/22/2025

Job Title : Medicaid Pending Representative Location : Long Island, NY Salary : Dependent on Experience Employment Type : Full-Time, In-Person

Description : We are looking for a motivated individual to join our team as a Medicaid Pending Representative. In this full-time role, you will be responsible for ensuring payer sources for Long-Term Care (LTC) patients, with a primary focus on Medicaid pending and private pay patients.

Responsibilities :

  • Verify payer sources, including Medicaid pending and private pay patients.
  • Facilitate the Medicaid application process, ensuring timely submission and follow-up.
  • Coordinate with residents and responsible parties to obtain necessary documents and signatures.
  • Review financial documents, including five years of bank statements.
  • Manage patient income setup, asset spend-down, and payment processes.
  • Ensure completion of pre-admission screenings (PAS) or equivalent for Medicaid patients.
  • Request fair hearings for denied cases and conduct weekly utilization reviews (UR).
  • Maintain consistent communication with responsible parties regarding asset balances.

Qualifications :

  • High School Diploma
  • Detail-oriented
  • Strong work ethic and team player
  • Strong organizational, multi-tasking, and prioritization skills
  • To Apply : Please email your resume to David@ASLLC.org .

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