Senior Medicaid Recertification Assistant

VNS Health; New York (NY); On-site; USD 29,000 - 36,000; Full time

Benefits offered by this job

Referral bonus opportunities

Generous PTO 20 days + 9 holidays

Health insurance for you and family

Employer-matched 401k

Job summary

VNS Health seeks a detail-oriented coordinator to assist members with Medicaid recertification and applications. You will update demographics in the Recertification Tracking Tool, follow up on missing information, and submit to HRA while addressing member inquiries. Strong communication and Excel/Word skills are essential.

The role includes preparing escalation packets, generating productivity reports, and supporting special projects under supervision.

Qualifications

• Associate's Degree in health, human services, or related field or equivalent work experience.
• Minimum two years experience in health care, insurance, or social services processing Medicaid applications.
• Strong written and verbal communication and customer service skills.
• Proficient with Microsoft Word and Excel for documentation and reporting.

Responsibilities

• Review recertification date and determine Medicaid eligibility.
• Process Medicaid applications and follow up for missing information.
• Submit applications to the HRA office and document properly.
• Respond to member inquiries regarding surplus payments and hardship claims.
• Prepare problem/escalated cases for management review and resolution.
• Generate weekly/monthly productivity reports for management.

Skills

Attention to detail

Communication skills

Customer service

Data entry

Education

Associate's Degree in health or related field

Tools

Microsoft Word

Excel

Job description

Overview

Contacts and assists VNS Health Plans members with Medicaid applications and recertification. Enters and updates member demographic information into the Recertification Tracking Tool. Identifies and investigates problematic recertification cases and presents for resolution. Works under general supervision.

What We Provide

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
• Employer-matched 401k retirement saving program
• Personal and financial wellness programs
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care and commuter transit program
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth and career advancement and CEU credits

What You Will Do

• Reviews patient recertification date and determines eligibility for Medicaid.
• Processes Medicaid applications. Conducts follow up contact with members when additional information is needed. Ensures proper documentation is recorded in the Recertification Tracking Tool.
• Submits Medicaid applications to Human Resources Administration (HRA) office.
• Assists members with any inquiries in regards to surplus payments when member claims hardship.
• Submits Stensen, Milestone, and PA applications to HRA for SSI members who have lost coverage.
• Prepares problem/escalated cases for management to review and resolve.
• Prepares weekly and monthly productivity reports for Management to review.
• Analyzes and investigates recurring issues; takes appropriate action including escalation to Senior Medicaid Recertification Coordinator or Supervisor. .
• Sends out Medicaid Recert packets to members in preparation for their Medicaid recertification.
• Scans, files into document repository; retrieves files as requested.
• Monitors members in the recertification process to ensure resolution.
• Participates in special projects and performs other duties as assigned.

Qualifications

Education

• Associate's Degree in health, human services, other related discipline or equivalent work experience required

Work Experience

• Minimum two years experience in health care, insurance, or social services processing bills and Medicaid applications required
• Effective oral, written, verbal communication and customer service skills required
• Personal Computer skills including Microsoft Word and Excel required
• Analytical skills, including compilation and analysis of data, report creation and recommendations based on findings preferred

Pay Range

USD $20.98 - USD $26.23 /Hr.

About Us

VNS Health has been committed to meeting the needs of New Yorkers for over 130 years. We're one of the largest nonprofit home- and community-based health care organizations in the country, and today, more than 11,500 team members work together to make a difference in the lives of more than 99,000 patients and members on any given day.