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Regional Medicaid Specialist
CommuniCare Health Services Corporate • Remote • Posted 3 days ago
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Remote • Full-time • $50,000-$55,000/yr • Mid Level
Job Highlights
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The Regional Medicaid Specialist at CommuniCare Health Services is responsible for assisting with the coordination of financial benefits available to residents in Caring Communities. This remote position involves occasional travel within Virginia and West Virginia for various tasks, including collecting documentation and attending meetings. The role requires knowledge of long-term care reimbursement laws, regulations, and guidelines, as well as strong communication and decision-making skills.
Responsibilities
- Assist the facility with gathering financial data from the resident, family, and responsible party.
- Review verifications and determine if qualifications for benefits have been met.
- Complete and submit applications to state Medicaid programs
- Become the authorized representative when applying for benefits
- Maintain proper documentation to support efforts with all applications submitted.
- Escalate difficult cases to management timely
- File appeals with the appropriate agency when necessary
- Build working relationships with local agency which produces the Level of Care/Pasarr Screen and local agency which determines Medicaid Eligibility
- Attend all Medicaid Pending Meetings for assigned facilities.
Qualifications
Required
- Knowledgeable with laws, regulations, and guidelines that pertain to long-term care reimbursement.
- 3-5 years of Long Term Care Business Office or Social Service experience in healthcare, preferably in a long term care setting
- Thorough understanding of Medicare, Medicaid, Private Insurance, managed care programs
- Ability to make independent decisions when circumstances warrant such action
- Tactful dealing with team members, other staff, residents, family members, visitors, government agencies, and the general public
- Willingness to seek out new methods and principles and incorporate them into existing practices
- Prior management training
- Basic computer literacy and skills
- Prior experience with related software applications
About CommuniCare Health Services Corporate
CommuniCare Family of Companies, based in Blue Ash, Ohio, is a leading provider of post-acute care services in the healthcare industry. They offer skilled nursing rehabilitation, post-acute care, and services like assisted living, striving to create a holistic healing environment for individuals to thrive. Founded in 1984, CommuniCare focuses on delivering high-quality care and addressing the unspoken needs of their clients through a comprehensive model of care.
Full Job Description
Regional Medicaid Specialist, Virginia
Communicare Health Services is currently recruiting a dynamic individual with prior Business Office or Admissions experience in Long Term Care for the position of Regional Medicaid Specialist for our facilities located in Virginia.
JOB SUMMARY
The position of Medicaid Specialist provides assistance with the coordination of financial benefits available to the residents in our Caring Communities.
Estimated Pay Range: $50k-55k/an
This is a work at home position, with occasional travel required within Virginia and West Virginia. Travel destinations as needed may include but are not limited to a resident and/or responsible party's home to collect documentation to support applications submitted, financial institutions, and Local Department of Job and Family Services.
JOB RESPONSIBILITIES
+ Assist the facility with gathering financial data from the resident, family and responsible party.
+ Review verifications and determine if qualifications for benefits have been met.
+ Complete and submit applications to state Medicaid programs
+ When appropriate become the authorized representative when applying for benefits
+ Maintain proper documentation to support efforts with all applications submitted.
+ Escalate difficult cases to management timely
+ File appeals with the appropriate agency when necessary
+ Build working relationships with local agency which produces the Level of Care/Pasarr Screen and local agency which determines Medicaid Eligibility
+ Attend all Medicaid Pending Meetings for assigned facilities.
WHAT WE OFFER
As a CommuniCare employee you will enjoy competitive wages and PTO plans. We offer you a menu of benefit options from life and disability plans to medical, dental and vision coverage, from quality benefit carriers. We also offer 401(k) with employer match and Flexible Spending Accounts.
QUALIFICATIONS/EXPERIENCE REQUIREMENTS
+ Must be knowledgeable with laws, regulations, and guidelines that pertain to long-term care reimbursement.
+ 3-5 years of Long Term Care Business Office or Social Service experience in healthcare, preferably in a long term care setting
+ Must possess a thorough understanding of Medicare. Medicaid, Private Insurance, managed care programs
+ Must have the ability to make independent decisions when circumstances warrant such action.
+ Must be able to deal tactfully with team members, other staff, residents, family members, visitors, government agencies, and the general public.
+ Must be willing to seek out new methods and principles and be willing to incorporate them into existing practices.
+ Prior management training.
+ Basic computer literacy and skills.
+ Prior experience preferably with related software applications.
About Us
A family-owned company, we have grown to become one of the nation's largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities. We have a single job description at CommuniCare, "to reach out with our hearts and touch the hearts of others." Through this effort we create "Caring Communities" where staff, residents, clients and family members care for and about one another.
#LI-Remote
Communicare Health Services is currently recruiting a dynamic individual with prior Business Office or Admissions experience in Long Term Care for the position of Regional Medicaid Specialist for our facilities located in Virginia.
JOB SUMMARY
The position of Medicaid Specialist provides assistance with the coordination of financial benefits available to the residents in our Caring Communities.
Estimated Pay Range: $50k-55k/an
This is a work at home position, with occasional travel required within Virginia and West Virginia. Travel destinations as needed may include but are not limited to a resident and/or responsible party's home to collect documentation to support applications submitted, financial institutions, and Local Department of Job and Family Services.
JOB RESPONSIBILITIES
+ Assist the facility with gathering financial data from the resident, family and responsible party.
+ Review verifications and determine if qualifications for benefits have been met.
+ Complete and submit applications to state Medicaid programs
+ When appropriate become the authorized representative when applying for benefits
+ Maintain proper documentation to support efforts with all applications submitted.
+ Escalate difficult cases to management timely
+ File appeals with the appropriate agency when necessary
+ Build working relationships with local agency which produces the Level of Care/Pasarr Screen and local agency which determines Medicaid Eligibility
+ Attend all Medicaid Pending Meetings for assigned facilities.
WHAT WE OFFER
As a CommuniCare employee you will enjoy competitive wages and PTO plans. We offer you a menu of benefit options from life and disability plans to medical, dental and vision coverage, from quality benefit carriers. We also offer 401(k) with employer match and Flexible Spending Accounts.
QUALIFICATIONS/EXPERIENCE REQUIREMENTS
+ Must be knowledgeable with laws, regulations, and guidelines that pertain to long-term care reimbursement.
+ 3-5 years of Long Term Care Business Office or Social Service experience in healthcare, preferably in a long term care setting
+ Must possess a thorough understanding of Medicare. Medicaid, Private Insurance, managed care programs
+ Must have the ability to make independent decisions when circumstances warrant such action.
+ Must be able to deal tactfully with team members, other staff, residents, family members, visitors, government agencies, and the general public.
+ Must be willing to seek out new methods and principles and be willing to incorporate them into existing practices.
+ Prior management training.
+ Basic computer literacy and skills.
+ Prior experience preferably with related software applications.
About Us
A family-owned company, we have grown to become one of the nation's largest providers of post-acute care, which includes skilled nursing rehabilitation centers, long-term care centers, assisted living communities, independent rehabilitation centers, and long-term acute care hospitals (LTACH). Since 1984, we have provided superior, comprehensive management services for the development and management of adult living communities. We have a single job description at CommuniCare, "to reach out with our hearts and touch the hearts of others." Through this effort we create "Caring Communities" where staff, residents, clients and family members care for and about one another.
#LI-Remote
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