What are the responsibilities and job description for the Medicaid Insurance Specialist - MassHealth position at Entyre Care?
About the Company - At Entyre Care, we believe that everyone deserves to live a dignified and independent life at home. To that end, we support friends and families in providing home care for their beloved ones with professional training and fair compensation. Our mission is to ensure that no caregivers feel overwhelmed or unsupported. Learn more about us at
About the Role - We are seeking a dedicated and knowledgeable Medicaid Health Insurance Specialist to join our team. The ideal candidate will possess a strong background in researching member insurance issues, counselling patients on insurance plans, and navigating the complexities of MassHealth LTSS services. This role is vital in ensuring that our patients receive the best possible insurance solutions tailored to their needs.
Responsibilities :
- Assess and determine Medicaid eligibility for clients, utilizing the knowledge of MassHealth LTSS services and the specific benefits associated with various forms of MassHealth.
- Provide guidance and counsel to patients regarding insurance plans, discussing risks and benefits to help them make informed choices.
- Engage with patients in their homes to assist with onboarding, ensuring a smooth transition into necessary services.
- Demonstrate a strong understanding of ACO / MCA plans within the Massachusetts health insurance system to aid clients in navigating their options.
- Participate in training programs to become a certified application counselor (CAC) with expenses covered by MassHealth.
- Research member insurance issues, addressing concerns related to benefits and eligibility, and help clients understand their options.
- Familiarize yourself with prior authorization processes related to LTSS and MassHealth services, including hospice services and personal care assistance (PCA).
- Display ambition and innovation in developing patient solutions through insurance options, constantly seeking to improve processes.
- Maintain a self-starter mentality by tracking key quantifiable metrics related to patient enrollment documents to enhance efficiency in the enrollment process.
- Practice keen listening skills to effectively connect with patients during insurance navigation, ensuring their needs are understood and met.
- Communicate effectively with internal staff regarding trends and issues related to insurance enrollment, fostering cooperative problem-solving.
Qualifications :
Entyre Care is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, disability, or veteran status.
