LTC-Financial Specialist| Dayton-Fairborn Area

MEDICAID SPECIALIST JOB DESCRIPTION Pay Rate: $50,000-$60,000 based on experience OBJECTIVE

To represent assigned Carespring locations in the Dayton/Fairborn area through interactions with facilities, residents, families, and county Medicaid offices, while working to obtain Medicaid eligibility for residents. Financial Specialists review, submit, and follow up on applications and verification documentation in pursuit of Medicaid eligibility. Financial Specialists serve as a resource and advocate for facilities, residents and families with a constant pursuit of opportunities to support positive outcomes with the Medicaid process.

• Review/Complete Financial Disclosure Form (FD) to determine if a resident needs or will need Medicaid assistance.
• Assess and resolve potential eligibility issues, including but not limited to: need for QIT, CSV of Life Insurance policies.
• Review for PASSR/LOC completion.
• Work with facilities, residents, and families to gather necessary verifications to accompany Medicaid application.
• Review/Complete Medicaid application, once submitted, update billing system with Medicaid pending.
• Calculate monthly Patient Liability (P/L) and enter into billing system.
• Collect monthly P/L from residents/families.
• Educate/advocate/communicate with residents, families, facilities, and county Medicaid offices during the pending process; keeping track of intake appointments, checking status of pending cases, ensuring gathering of additional verifications needed, and expediting processing of pending cases.
• Ensure annual recertifications are completed timely.
• Maintain electronic records and documentation of pending cases in HCS and maintain accurate pending logs of current cases.

• In-depth knowledge of Medicaid eligibility requirements.
• At least 3 years relevant Medicaid experience.
• Candidates should be solution focused working towards outcomes that positively impact the resident, families, and facilities.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations that do not cause an undue hardship on the company may be made to enable individuals with disabilities to perform the essential functions, as long as that would not hinder or prevent performance of duties, or be of a safety concern.

Equal Opportunity Employer
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