Medicaid Enrollment Specialist - Washington, United States - Iona Senior Services

Description

Iona is pleased to announce that we are hiring a full-time Medicaid Enrollment Specialist for our Washington Home Center location


About Iona

Iona is a warm and collegial workplace that promotes excellence in client services and is committed to diversity, inclusion, and the professional growth of employees.

SUMMARY:


RESPONSIBILITIES:


Enrollment:

• Oversees admission process into the Center with emphasis on managing the enrollment funnel to grow the program to capacity and meet budgeted revenue goals.
• Facilitate enrollment process through initial interview, tour, guest day and initial data collection.
• Ensure each incoming participant has a funding source and navigates them through the necessary stages to enroll in that funding source.
• This includes Medicaid, private pay, sliding scale/cost sharing, VA or other future sources.
• Track all enrollment progress in Iona's established systems (i.e. Access)
• Community outreach including building relationships with potential referral sources.
• Respond to inquiries and effectively present program information to clients, referral sources, and caregivers.
• Ensure that all necessary materials for enrollment are provided to the responsible party promptly.
• Strive toward capacity enrollment.
• Communicate pertinent financial information and resources such as rates, financial support tools, and scholarships.
• Manage medical chart for admissions and discharge process.
• Support Director with maintaining up to date client information in Iona's internal spreadsheets/ Electronic Management System

Medicaid Management:

• Facilitate the enrollment of eligible Medicaid participants and assist in developing policies to ensure Medicaid enrollment.
• Support Director with Medicaid Compliance
• Including: Application submission for UHC, Stateplan and EPD Waiver
• Conduct internal audits twice a year to ensure compliance.
• Keep up to date with Medicaid changes/updates and inform Assistant Director and Director of pertinent information.
• Attend weekly and monthly Medicaid meetings.
• Review Transmittals
• Complete Medicaid's Quarterly Snapshot Sheets and Quarterly Reports.
• Follow through with DHCF for any billing issues or discrepancies.
• Identify potential Medicaid participants during the enrollment process.
• Actively support Caregiver in Application from start to finish.
• Ensure participant recertification process from EPOF to PA in consultation with social worker.

Billing:

• Manage accurate monthly billing for all participants from start to finish

This includes:

• Keep attendance tracking for billing purposes.
• Enter attendance into billing data management spreadsheet/system to submit to finance.
• Assure all attendance data and billing data are complete and accurate.
• Maintain clear communication with Iona's finance department for any billing issues or discrepancies.
• Assure DHCF reimbursement for services is up to date.

Community Outreach:

• Community outreach including building relationships with DACL MES, Case Managers and other Medicaid affiliated agencies.

Other:

• Other duties as assigned.

REQUIREMENTS:

• Bachelor's degree in the human service field required. Certification in healthcare administration, medical billing and coding, or a related field preferred.
• Mandatory 3+ years' experience working in healthcare administration, insurance verification, medical billing, customer service, or a related field is often preferred.
• A strong understanding of Medicaid eligibility criteria, enrollment procedures, and regulations is essential.
• Must possess exceptional verbal and written communication skills.
• Strong customer service skills.
• Strong organizational skills and attention to detail.
• Knowledge of healthcare privacy laws, such as HIPAA, and adherence to confidentiality guidelines are essential.
• The ability to troubleshoot problems, analyze information, and find solutions.
• Computer literacy with proficiency in Microsoft Office Suite required.
• Initial and annual chest xray/PPD or medical certification required.
• First aid and CPR certification required.

Iona has a robust benefits package which includes health, dental, and life insurance, vacation, and a 403(b)-retirement plan. Compensation is commensurate with experience.


Pay:
$60, $65,000.00 per year


Benefits:

• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Referral program
• Retirement plan
• Vision insurance

Schedule:

• 8 hour shift

Education:

• Bachelor's (required)

Experience:

• Medicaid enrollment: 2 years (required)

License/Certification:

• Certification in Healthcare Administration, Medical Billing (required)

Ability to Relocate:

• Washington, DC 20020: Relocate before starting work (required)

Work Location:
In person