What are the responsibilities and job description for the Medicaid Specialist -Long Term Care Facility position at Shady Grove Center For Nursing & Rehabilitation?
Review and process Medicaid applications, ensuring all necessary documentation is complete and accurate.
Determine eligibility for Medicaid services based on federal and state guidelines, analyzing applicants’ financial and medical information.
Coordinate with healthcare providers to verify patient eligibility for Medicaid coverage and to facilitate billing processes.
Provide guidance and support to applicants and beneficiaries on Medicaid benefits, coverage limits, and the renewal process.
Implement case management strategies for beneficiaries, including assessing needs, coordinating services, and monitoring care plans.
Investigate and resolve discrepancies or issues related to Medicaid eligibility, benefits, and claims, including potential fraud cases.
Liaise with state and federal agencies to ensure compliance with Medicaid policies and regulations.
Develop and conduct training sessions for new Medicaid Specialists and other staff members on Medicaid policies, procedures, and best practices.
Experience
2 years as a Medicaid Specialist in a Long Term Care Facility
Advanced Medicaid Knowledge
Other
Must be able to complete a multi-disciplinary interview process successfully.
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