• Entitlement/Enrollment Coordinator

    Location US-NY-New York
    Posted Date 1 week ago(1/10/2019 1:45 PM)
    Job ID
    2019-12536
    # Positions
    1
    Facility
    ArchCare Community Life
    Experience (Years)
    2
    Category
    Administrative
    Work Days Per Week
    5
    Shift
    D
    Shift Start Time
    9:00AM
    Shift End Time
    5:00PM
    Type
    Full-Time
    # Hours
    35
  • Overview

    Monitor the track and submission of Medicaid Pending cases to assure that resident representative is filing timely with county, then follows up until Medicaid approvals are obtained. Monitors yearly recertification of Medicaid and ensures timely completion of Medicaid recertifications. Monitors Medicaid surpluses and tracks payments. Files Medicaid & Medicare financial information in accordance with HIPAA regulations. Assist participants in obtaining entitlement benefits. Delivers all information to HRA (Human Resources Administration). Reviews Maximus files.

    Responsibilities

    • Maintain log of Medicaid Pending participants and provides follow up and reporting on Medicaid pending cases.
    • Works on new enrollee Medicaid applications and pool trust enrollment.
    • Track and supply facility with Medicaid approval discrepancies of NAMI amounts and pick up dates until corrected by county.
    • Monitors Medicaid and Medicare status of each participant on an on-going basis.
    • Submit and deliver all required documentation to HRA ( Human Resources Administration)
    • Submit and communicate information to Wipro (formally Infocrossing
    • Visit participants homes when necessary to collect documentation for renewal of Medicaid or potential new members who do not have Medicaid
    • Reconcile prospective members in Mediture from month to month.
    • Reconcile members working with the D file & L file State reports.
    • Review all response files from Maximus and follow workflows for each file.
    • Correspond with Senior Planning services for member certifications.
    • Responds to member inquires via telephone and/or by mail.
    • Answer phones for member inquiries.
    • Performs all other duties as assigned

    Qualifications

    • 2 Years Healthcare or Managed Care Experience 
    • HS Diploma/GED 

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