MEDICAID ENROLLMENT SPECIALIST (bilingual spanish preferred)

Intermedia Group Inc.; Newark (NJ); On-site; USD 59,000 - 78,000; Full time

Job summary

Intermedia Group Inc. in Newark, NJ is seeking a Medicaid Enrollment Specialist to drive enrollment efforts for the PACE program. You will gather documentation, visit seniors' homes, and coordinate with the county DPSS to submit and manage Medicaid enrollments, including appeals.

The role emphasizes bilingual Spanish/English communication, knowledge of Medicaid rules, and conducting enrollment events at centers, housing, hospitals, and virtually to attract eligible participants.

Qualifications

• Bachelor’s degree in relevant field preferred, an additional five (5) years of relevant Medicaid enrollment experience may be substituted
• Bilingual (Spanish/English) strongly preferred
• Minimum of three (3) years of experience working directly with the county DPSS submitting, managing, and appealing Medicaid enrollments
• Demonstrated knowledge and experience with complex Medicaid enrollment case management

Responsibilities

• Gather all necessary documentation to create, submit, doggedly pursue, and appeal Medicaid enrollments for prospective participants.
• Visit senior’s homes as needed to gather necessary documentation to submit complete applications
• Maintain a strong working relationship with the Department of Public and Social Services (DPSS) at the county to ensure seamless enrollment workflow, adhere to deadlines and ensure compliance with DHCS and CMS guidelines and policies
• Create and conduct Medicaid enrollment events to attract prospective participants: Every week in each of the centers in territory, Monthly at senior housing, hospitals, senior centers, churches, Monthly virtual enrollment sessions
• Demonstrate in-depth knowledge of Medicaid rules, processes, practices, and options to enroll including but not limited to share of cost, spousal impoverishment protections, and appeals processes

Skills

Bilingual Spanish/English

Medicaid enrollment experience

County DPSS coordination

Education

Bachelor’s degree in relevant field

Job description

• Newark, NJ
• $58,718 to $77,521

OPEN JOB: MEDICAID ENROLLMENT SPECIALIST (bilingual spanish preferred)

LOCATION: Newark, New Jersey

BASE SALARY: $58,718 to $77,521

The Outreach and Enrollment Team is the first touchpoint prospective participants have with the firm. A vital part of the PACE (Program for All Inclusive Care for the Elderly) enrollment process is aiding those who qualify with the Medicaid Enrollment process.

The Medicaid Enrollment Specialist focuses on successfully enrolling prospective participants in Medicaid. The Medicaid Enrollment Specialist is a member of the Marketing, Outreach, and Enrollment (MOE) team and provides back-up and support to Outreach and Enrollment functions as assigned.

Essential Job Duties:

• Gather all necessary documentation to create, submit, doggedly pursue, and appeal Medicaid enrollments for prospective participants.
• Visit senior’s homes as needed to gather necessary documentation to submit complete applications
• Maintain a strong working relationship with the Department of Public and Social Services (DPSS) at the county to ensure seamless enrollment workflow, adhere to deadlines and ensure compliance with DHCS and CMS guidelines and policies (for example, marketing guidelines and denials policies)
• Create and conduct Medicaid enrollment events to attract prospective participants:
• Every week in each of the centers in territory
• Monthly at senior housing, hospitals, senior centers, churches
• Monthly virtual enrollment sessions
• Demonstrate in-depth knowledge of Medicaid rules, processes, practices, and options to enroll including but not limited to share of cost, spousal impoverishment protections, and appeals processes

Job Requirements:

• Bachelor’s degree in relevant field preferred, an additional five (5) years of relevant Medicaid enrollment experience may be substituted
• Bilingual (Spanish/English) strongly preferred
• Minimum of three (3) years of experience working directly with the county DPSS submitting, managing, and appealing Medicaid enrollments
• Demonstrated knowledge and experience with complex Medicaid enrollment case management