Medicaid Coordinator Bilingual English/Spanish Brooklyn, NY

Med-Metrix

New York (NY)

On-site

USD 42,000 - 64,000

Full time

14 days+

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Job summary

Med-Metrix is seeking a Medicaid Coordinator to support hospital clients by gathering and processing Medicaid applications for in-house and discharged patients. You will screen eligibility by phone, enroll patients, verify information, and maintain PHI in HIPAA-compliant systems.

Responsibilities include data entry, status tracking, and preparing reports in Excel, with a focus on accuracy and urgency to ensure prompt payment to hospitals.

Qualifications

  • High School Diploma or equivalent is required.
  • Bilingual English/Spanish is required.
  • Experience with ePACES and LexisNexis is a plus.
  • Experience in healthcare or insurance plans is a plus.
  • Proficiency in Microsoft Office Suite is required.
  • Strong investigatory and researching skills.
  • Strong interpersonal and communication skills.

Responsibilities

  • Call patients and screen for Medicaid eligibility on cases referred by client hospital over the phone.
  • Enroll patients in health insurance coverage via Marketplace or by completing the paper application package to submit to HRA/Local Department of Services.
  • Review, validate and process confidential information.
  • Research and verify patient contact information using search engines and hospital computer systems.
  • Research and resolve Medicaid-related issues.
  • Send various automated letters to patients from the Firms database.
  • Retrieve information from hospital databases.
  • Verify insurance.
  • Update the Firms internal database with all work done on an account (actions taken to communicate with patients, code, account).
  • Track application status via the Marketplace and/or call LDSS/HRA for status.
  • Keep track of 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 Market Place/Department of Social Services.
  • Use, protect and disclose patients protected health information (PHI) only in accordance with HIPAA standards.
  • Understand and comply with Information Security and HIPAA policies and procedures at all times.
  • Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties

Skills

Bilingual English/Spanish
Investigative & research
Administrative experience
Interpersonal skills
Written & verbal communication

Education

High School Diploma or equivalent

Tools

Microsoft Office Suite
ePACES
LexisNexis

Job description

Job PurposeThe Medicaid Coordinator is part of a team that works to complete the Medicaid application process for patients of our hospital clients for both in-house and discharged patients. The Medicaid Coordinator assists in gathering and processing information from patients. They will follow through expeditiously to assist patients in obtaining Medicaid, which ensures prompt payment to our client hospitals.

Duties and Responsibilities
  • Call patients and screen for Medicaid eligibility on cases referred by client hospital over the phone
  • Enroll patients in health insurance coverage via Marketplace or by completing the paper application package to submit to HRA/Local Department of Services
  • Review, validate and process confidential information
  • Research and verify patient contact information using search engines and hospital computer systems
  • Research and resolve Medicaid-related issues
  • Send various automated letters to patients from the Firms database
  • Retrieve information from hospital databases
  • Send the Medicaid Clerk a request for third party information and review upon receipt
  • Verify insurance
  • Update the Firms internal database with all work done on an account (actions taken to communicate with patients, code, account)
  • Track application status via the Marketplace and/or call LDSS/HRA for status
  • Keep track of 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 Market Place/Department of Social Services
  • Other duties as assigned
  • Use, protect and disclose patients protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
  • Understand and comply with Information Security and HIPAA policies and procedures at all times
  • Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties Qualifications
  • 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 and the 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 oriented
  • Excellent written and verbal communication skills required

Hours M-F 7a-330p for 2 weeks & Tues-Sat 7a-330p for 2 weeks

Working Conditions
  • Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.
  • Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
  • Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
  • Work Environment: The noise level in the work environment is usually minimal.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-me
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