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About the Role

The Medicaid Coordinator is responsible for managing the Medicaid application process for hospital clients' patients, ensuring timely payments to hospitals by assisting patients in obtaining Medicaid coverage.

Responsibilities

• Call patients to screen for Medicaid eligibility over the phone.
• Enroll patients in health insurance coverage via Marketplace or by completing paper applications.
• Review, validate, and process confidential patient information.
• Research and verify patient contact information using search engines and hospital systems.
• Research and resolve Medicaid-related issues.
• Send automated letters to patients from the Firm’s database.
• Retrieve information from hospital databases.
• Request and review third-party information from the Medicaid Clerk.
• Verify insurance coverage.
• Update the Firm’s internal database with all account activity.
• Track application status via the Marketplace and/or by contacting LDSS/HRA.
• Monitor the status of denied applications throughout the Fair Hearing process.
• Prepare and review reports on open accounts using Microsoft Excel.
• Schedule and coordinate meetings with patients.
• Manage calendars.
• Respond to requests for additional documents from Marketplace/Department of Social Services.
• Use, protect, and disclose patients’ protected health information (PHI) in accordance with HIPAA standards.
• Comply with Information Security and HIPAA policies and procedures.
• Limit viewing of PHI to the minimum necessary to perform duties.

Requirements

• High School Diploma or equivalent is required.
• Bilingual English/Spanish is required.
• Experience with ePACES and LexisNexis is a plus.
• Experience in the field of healthcare or insurance plans is a plus.
• Strong investigatory and researching skills.
• Must have had administrative experience.
• Proficiency in Microsoft Office Suite.
• Ability to use the internet and learn databases.
• Strong interpersonal skills, ability to communicate well at all levels of the organization.
• Strong problem-solving and creative skills.
• Ability to exercise sound judgment and make decisions based on accurate and timely analyses.
• High level of integrity and dependability with a strong sense of urgency and results orientation.
• Excellent written and verbal communication skills required.
• Must possess a smart-phone or electronic device capable of downloading applications for multifactor authentication and security purposes.
• Ability to move around the work area, sit, perform manual tasks, operate office equipment, extend arms, kneel, talk, and hear.
• Ability to follow directions, collaborate with others, and handle stress.

Skills

• Microsoft Office Suite
• Internet navigation
• Database learning
• Interpersonal communication
• Problem-solving
• Creative thinking
• Judgment
• Decision-making
• Integrity
• Dependability
• Urgency
• Results orientation
• Written communication
• Verbal communication

Education Level

• High School Diploma or equivalent

About the Company

• Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

Equal Opportunity

• Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.