Job: Senior Medicaid Specialist - Lowry

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Job Description

Senior Medicaid Specialist - Lowry

  • Location: CO, Denver
  • Schedule: Regular Full-time
  • Department: 322 - Medicaid Department
  • Facility: LOWRY - InnovAge-Lowry
  • Date published: 8-Sep-2017
Job Description

Job Summary

Under the supervision of the Medicaid Controller/Analyst, the Medicaid Specialist works in conjunction with the Enrollment Representatives in overseeing the Medicaid applications being submitted on behalf of Innovage PACE Participants to the County Technicians.

Essential Functions and Work Responsibilities

Functional Category: Administration

Estimated Percent of time Spent 80%

Reviews applications from the Enrollment Representative Group and works closely with them in obtaining necessary documentation needed for Medicaid approval. Works as the primary contact for the enrollment representative for ongoing training and best practices.

Tracking system in place and provided to the Medicaid Controller showing applications received and the status of each application from first submission to approvals.

Ensures compliance with all State Medicaid Rules and Regulations with applications being submitted by Innovage to the County Agencies. Fulfilling this by keeping current on updates of Federal and State rules and regulations that pertain to Medicaid, Straight Medicaid, LTC, Spousal Impoverishment and Trusts, Food Stamps, Old Age Pension (OAP) and other Medicaid programs for which IGCP participants may be eligible.

Works with Accounts Receivable and the Medicaid Controller/Analyst to track on a monthly basis Medicaid issues with IGCP participants.

Tracking private pay clients and instrumental in obtaining a smooth transition to Medicaid eligibility.

Ensures that all IGCP Medicaid staff acquires and maintain the necessary Medicaid knowledge needed for the position in collaboration with the Medicaid Redetermination Manager and the Medicaid Controller.

Job Qualifications

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

REQUIRED

Education

High School diploma or GED required.

Licensure, Certification, Registration or Designation

Requires a valid state issued drivers license, personal transportation, good driving record and auto insurance as required by law.

Work Experience and Qualifications

A minimum of one year experience with the CBMS Medicaid system and current knowledge of Medicaid systems and benefits.

A minimum of one year experience working with the frail or elderly is required.

Other Knowledge Skills and Abilities Required

Computer Skills

Must be computer proficient and possess experience with Microsoft Word, Excel, and Outlook.

Must be able to quickly learn specific software and new applications.

Mathematical/Financial Skills

Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.

Able to analyze data and statistics and draw reasonable conclusions and compile accurate reports.

Language Skills


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