Medicaid Pending Representative

Care Network; Village of Valley Stream (NY); Sur place; USD 42 000 - 64 000; Plein temps

Résumé du poste

Care Network in Long Island, NY is seeking a Medicaid Pending Representative. This full-time, in-person role focuses on verifying payer sources for LTC patients, including Medicaid pending and private pay cases.

You will facilitate Medicaid applications, collect documents, review financial records, and assist with asset spend-down and pre-admission screenings, ensuring timely processes and clear communication with residents and responsible parties.

Qualifications

• High School Diploma required.
• Detail-oriented with strong organizational skills.
• Excellent teamwork and work ethic.
• Ability to multitask and prioritize effectively.

Responsabilités

• Verify payer sources, including Medicaid pending and private pay patients.
• Facilitate the Medicaid application process, ensuring timely submission and follow-up.
• Coordinate with residents and responsible parties to obtain necessary documents and signatures.
• Review financial documents, including five years of bank statements.
• Manage patient income setup, asset spend-down, and payment processes.
• Ensure completion of pre-admission screenings (PAS) or equivalent for Medicaid patients.
• Request fair hearings for denied cases and conduct weekly utilization reviews (UR).
• Maintain consistent communication with responsible parties regarding asset balances.

Connaissances

Detail-oriented

Team player

Organizational skills

Multi-tasking

Formation

High School Diploma

Description du poste

Job Title: Medicaid Pending Representative Location: Long Island, NY Salary: Dependent on Experience Employment Type: Full-Time, In-Person

Description: We are looking for a motivated individual to join our team as a Medicaid Pending Representative. In this full-time role, you will be responsible for ensuring payer sources for Long-Term Care (LTC) patients, with a primary focus on Medicaid pending and private pay patients.

Responsibilities:

• Verify payer sources, including Medicaid pending and private pay patients.
• Facilitate the Medicaid application process, ensuring timely submission and follow-up.
• Coordinate with residents and responsible parties to obtain necessary documents and signatures.
• Review financial documents, including five years of bank statements.
• Manage patient income setup, asset spend-down, and payment processes.
• Ensure completion of pre-admission screenings (PAS) or equivalent for Medicaid patients.
• Request fair hearings for denied cases and conduct weekly utilization reviews (UR).
• Maintain consistent communication with responsible parties regarding asset balances.

Qualifications:

• High School Diploma
• Detail-oriented
• Strong work ethic and team player
• Strong organizational, multi-tasking, and prioritization skills