Medicaid Coordinator - Bilingual English/Spanish - Brooklyn, NY

Med-Metrix; New York (NY); On-site; USD 45,000 - 60,000; Full time

Job summary

Med-Metrix is seeking a Medicaid Coordinator to join a team that processes Medicaid applications for hospital clients, including in-house and discharged patients. The role focuses on gathering and validating information, pursuing Medicaid enrollment, and ensuring timely submission to support prompt payments to our clients.

Key duties include screening eligibility by phone, enrolling through Marketplace or by paper forms, verifying data, and maintaining PHI per HIPAA.

Qualifications

• High School Diploma or equivalent required.
• Bilingual English/Spanish required.
• Experience with ePACES and LexisNexis is a plus.
• Healthcare or insurance experience a plus.
• Strong investigative and researching skills.
• Administrative experience required.
• Proficiency with Microsoft Office.
• Ability to use the internet and learn databases.
• Strong interpersonal and communication skills.
• Strong problem solving and decision making.
• High integrity and dependability with urgency and results orientation.
• Excellent written and verbal communication skills.

Responsibilities

• Call patients to screen Medicaid eligibility.
• Enroll patients in Marketplace or by completing paper applications.
• Review, validate and process confidential information.
• Research and verify patient contact information.
• Research and resolve Medicaid-related issues.
• Update the Firm’s internal database with work done on accounts.
• Track application status via Marketplace and LDSS/HRA.
• Prepare and review reports on open accounts using Excel.

Skills

Bilingual English/Spanish

Investigative skills

Microsoft Office

Communication skills

Research skills

Internet databases

Education

High School Diploma

Tools

ePACES

LexisNexis

Job description

Job Purpose

The 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.

Job Purpose

The 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 Firm’s database
• Retrieve information from hospital databases
• Send the Medicaid Clerk a request for third party information and review upon receipt
• Verify insurance
• Update the Firm’s internal database with all work done on an account (actions taken to comminicate 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

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

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

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-merit based factors, or any other characteristic protected by federal, state or local law.