Description

Responsibilities 

• Manage all intake, admissions, and discharges from all systems, ensuring all paperwork is signed, handled, placed on systems, and communicated effectively.
• Oversee all Therap billing processes, acting as a liaison to ensure group homes (GHs) complete attendance and notes for billing.
• Handle all RFMS processing as the “Resident Trust Custodian,” managing transactions, cash flow, and reconciliations.
• Manage all receipts, including grocery and Divvy card transactions.
• Work collaboratively with the billing department and regional offices for troubleshooting issues impacting billing and cash flow.
• Assure service authorizations in Therap are created and maintained to avoid loss of services and payments.
• Assure new residents and amendments to services are updated and/or entered in Therap.
• Generate billing data from Therap to the billing specialist, when necessary, and assure compliance with all eligibility requirements.
• Monitor individual authorizations for expiration and determine the course of action.
• Update billing department on eligibility and authorization status.
• Resolve social security issues and follow up to prevent the suspension of benefits or reinstate benefits if suspended.
• Assist in the reconciliation of claim denials due to state eligibility and waiver requirements.
• Manage the benefits and entitlements for all individuals receiving supports and services, including OTDA, SNAP benefits, Medicaid, Medicare, and Social Security (SS) benefits.
• Complete all SSI eligibility packets as Social Security (SS) requests them.
• Attend all Social Security (SS) redetermination calls and arrange when necessary.
• Assist with collecting all necessary documentation for Medicaid redeterminations.
• Submit and follow up with Social Security (SS) regarding rep payee applications.
• Point person to contact Social Security (SS) for all and any updated income letters.
• Prepare and assist in annual reassessments and waiver recertifications.
• Ensure the state application packet and requested information is completed for individuals.
• Ensure changes to individuals' services are entered and submitted to required entities.
• Work closely with operations management to ensure assets and bank accounts (RFMS) are in good standing to maintain benefits.
• Assist with the compilation of data for monthly reporting, including vacancy, census, variance reports, etc.
• Maintain programmatic records and documentation for individuals receiving supports.
• Prepares required documents for local, state, and federal governmental agencies.
• Occasionally will participate in pre-placement meetings for all new admissions, when necessary.
• Employee must cooperate with the license and department staff in any inspection, inquiry, or investigation.
• Employment is contingent upon successful completion of checks of criminal background, central registry, child abuse registry, and drug testing.
• Other duties as assigned.

Minimum Requirements 

• Excellent verbal, written, interpersonal and communication skills
• Knowledge and understanding of local and regional regulatory operations
• Knowledge and understanding of state regulations
• Understanding and commitment to community-based support for persons with disabilities
• Experience with intake and admissions
• Excellent time management skills
• Familiarity with social security and Medicaid
• Working knowledge of ICD-10 codes
• Therap experience is a plus
• Proficiency in Microsoft Outlook, Microsoft Word, and Excel
• High school diploma or equivalent; bachelor’s or associate degree preferred
• At least two years’ experience preferably with a background in admissions, social services,administration and/or public relations

Working Conditions 

• May be required to be on-call in cooperation with other management staff
• Moderate overtime required throughout the year
• Valid driver’s license with good driving record
• Minimal hazards, general office working conditions

• Competitive Insurance Benefits (Medical, Dental, Vision)
• Paid Holidays—Including a Birthday Holiday
• Generous PTO
• Employee Incentive & Discount Programs
• 403b Retirement Plan
• Incredible career growth opportunities

Community Options is an Equal Opportunity Employer   M/F/D/V