Company: Premier Cadbury
Location: Cherry Hill
Posted on: November 21, 2022
Premier Cadbury - Medicaid Specialist
The Medicaid Specialist is responsible for the timely and accurate
completion and review of Medicaid Pending applications to ensure
all required documentation is made available and gathered for
timely processing to the County. Further is responsible to ensure
that policy and procedures in the business office are followed in
accordance with current applicable Federal, State and local
standards, guidelines and regulations. - -Ensures that all
information uploaded into the billing software is accurate and
Works one on one with residents, responsible parties, and families
to ensure the Medicaid Application process starts within 24-48
hours of admission for any admission that will become Medicaid
Pending. Secures authorizations to represent as applicable.
Educates residents, responsible parties, families in the Medicaid
Process and communicates documents required to complete the
Informs Business Office Manager promptly if there is no cooperation
or a delay in cooperation from a resident, responsible party,
family in the Medicaid Application Process
Ensures complete confidentiality of financial, HIPAA protected
information of residents
Responsible for the completion of the Options package for Aging and
Adult Services for the clinical approval of Medicaid. -
Responsible for the tracking and ensuring the MA51 is returned from
the physician timely. - -Further is responsible for ensuring the
MA51 and the PASSAR match as it may result in a clinical
Responsible to forward the OBRA letter with the Medicaid
application if the resident tis deemed a Target admission by the
Commonwealth of Pennsylvania and an Options request is not needed.
- -Responsible for obtaining such documentation from the Social
Services or Admissions Department.
On a daily basis will call residents, responsible parties, families
and financial institutions and other affected agencies and
financial institutions to assist in attempting to obtain a large
number verification that is needed by the Commonwealth of
Pennsylvania to secure a Medicaid Grant
Responsible for ensuring Spousal cases include the additional
information required by the County to ensure a timely processes and
approval of a Medicaid Application.
Responsible to ensure the resident and or responsible party or
family member understands and signs the Patient Liability which is
due on a monthly basis
Responsible to ensure that Direct Deposit if secured. - -Reports to
the Business Office Manager if there is no compliance and a Rep
Payee is secured for Social Security
Responsible to complete the Rep Payee Application and ensuring the
Rep Payee Application is completed promptly and accurately
Responsible to keep and update the Medicaid Pending log on a daily
Works collaboratively with the applicable County office to ensure
they have all required documentation
Responsible to attend face to face interviews at the County
Assistance Office in order to secure a grant if families are
uncooperative or unable to attend
Responsible for ensuring the County Assistance Office is in receipt
of all verifications.
Responsible for ensuring that when the Medicaid Grant is obtained
the appropriate persons (third party biller, BOM and RNAC) are
Responsible for ALL active in-house Medicaid resident's yearly
Comply with Health Insurance Portability and Accountability Act
Must be an active participant in the facility's Quality
Assurance/Performance Improvement (QAPI) program and Performance
Improvement Project (PIP) and carry out roles and responsibilities
as assigned. - -Must attend trainings for QAPI, follow policies and
procedures in support of QAPI efforts, and support QAPI initiatives
and findings. - -Must also report potential or actual
non-compliance issues to the facility's QAPI committee.
Perform other reasonable duties as assigned by supervisor.
Must have two years of work experience in Long Term Care.
Must be efficient, maintain confidentiality, exhibit good judgment,
and have the ability to speak and write effectively.
Must possess good communication and people skills.
Must be knowledgeable of all Medicaid legal regulations, guidelines
and best practices.
Must understand the basics of working in the business office and
importance of following established processes.
- - - - - - - -Must possess an aptitude for problem solving.
- - - - - - - -Employment is contingent on completion of all
pre-employment screenings inclusive of criminal background check
and Medicaid Exclusion Screening, both indicating negative
Keywords: Premier Cadbury, Cherry Hill , Medicaid Specialist, Other , Cherry Hill, New Jersey
Didn't find what you're looking for? Search again!