Medicaid Service Coordinator (Temp) - Start Treatment and Recovery Centers

The Medicaid Coordinator (MC) is a resource and support to the Clinical and Operational staff to maximize reimbursement with Managed Care Organizations and other payers.   The MC will be responsible for serving as a liaison with patients, and the organization by providing stellar customer service. 
*This is a temp position*

ESSENTIAL FUNCTIONS 

• Verify and continuously monitor patient Medicaid eligibility to obtain access to services. 

• Prepare and submit monthly Managed Care Enrollment/Roster Reports and weekly encounter reports. 

• Assist patients with applying for Health Insurance coverage via the NYS Marketplace and HRA Provider Portal. 

• Assists patients with Public Transportation Automated Reimbursement (PTAR) Inquiries. 

• Monitor Medicaid re-certification timeframes for each active patient, and contact patient or primary caregiver in person, by phone or letter to arrange a meeting, two months prior to the Medicaid expiration date. 

• Contributes to the teams’ efforts to treat every member with respect, courtesy, and fairness in a way that provides superior customer service. 

• Assist with Managed Care, Medicaid and private pay billing issues to maximize revenues. 

• Escalate Medicaid Managed Care and operational issues to Managed Care Relations Manager for resolution. 

• Maintain the highest level of integrity, courtesy, and respect while interacting with members, employees and business contacts. 

• Engage patients for primary care services. 

• Performs other duties as assigned. 

REQUIRED QUALIFICATIONS  

• Bachelor's degree 

• 3 years of specific industry experience in Medicaid Managed Care or HMO 

• Experience with patient health information (PHI) databases (i.e EPACES and eCW). 

• Familiar with Medicaid Eligibility guidelines and processes (i.e Surplus). 

• Familiar with claims processing, billing and credentialing. 

• Computer literacy with knowledge of Microsoft Office applications. 

• Strong attention to detail and ability to handle sensitive and confidential information. 

• Excellent communication and interpersonal skills, with the ability to effectively collaborate with cross-functional teams. 

• Critical thinker and problem solver with high emotional quotient. 

• Proactive and independent with the ability to take initiative. 

• Excellent time management skills with a proven ability to meet deadlines. 

ADDITIONAL REQUIREMENTS 

• Able to work outside the traditional hours of 9:00 am to 5:00 pm upon request. 

• Able to successfully become a Certified NYS Marketplace Assistor.   

SUPERVISORY RESPONSIBILITIES 

 This position has no supervisory requirements. 

PHYSICAL REQUIREMENTS 

These physical demands are representative of the physical requirements necessary for an employee to successfully perform the essential functions of the job. Reasonable accommodation can be made to enable people with disabilities to perform the described essential functions of the position which are reviewed in each individual case.  

While performing the responsibilities of the role, the employee is required to talk and hear. The employee is often required to sit and use his or her hands and fingers, to handle or feel. The employee is occasionally required to stand, walk, reach with arms and hands, climb or balance, and stoop, kneel, crouch, or crawl. The employee may be required to lift an object weighing up to 50 lbs., with or without assistance. The vision abilities required by this job include close vision. 

LIMITATIONS & DISCLAIMER 

The above job description is meant to describe the general nature and level of work being performed; it is not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required for the position. 

EQUAL EMPLOYMENT OPPORTUNITY STATEMENT  

START provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. 

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.