Medicaid Eligibility Specialist The Hermitage HealthCare - 2.9 Worcester, MA Job Details Full-time 1 day ago Benefits Paid holidays Disability insurance Health insurance Dental insurance 401(k) Tuition reimbursement Vision insurance Life insurance Qualifications Long term care experience Welfare eligibility determination Medicaid health insurance Medicaid regulations Medicaid Full Job Description Full Time Position The Hermitage Healthcare is seeking an exceptional Medicaid Eligibility Specialist Responsibilities include but are not limited to: Review and approve all Medical Eligibility Applications prior to submission. Review, approve, and submit every Medicaid Financial Eligibility Application and attached documentation for assigned SNFs. Proactively contact County representative for assigned SNFs to assure applications are progressing and expedite requests for additional information in advance of formal notice. Interface with customer or representative to secure new grants (from County submission until Grant Approval) and to maintain grant status (Eligibility Re-Determinations). Determine response to Grant Discontinuation and/or Denials. Lead response, which may include Appeal, Re-Application, or Acceptance. Recommend legal or outsourced services to Administrator. May liaise on behalf of SNF. Communicate billing requirements to SNF based on Grant Approval or Denial, e.g. Retro-adjustments, Write-off, Adjustments. Monitor SNF activity for potential applications, new applications, pending applications (with A/R balances), approved applications, appealed applications, and re-determination of continuous eligibility application. Work with SNF to mitigate NSHC financial risk associated with Uncooperative Customers, Process Breakdown, and Administrator Escalations.

Required Qualifications and Skills:

College degree preferred with a minimum of 5-7 years experience in Long Term Care /Healthcare industry or equivalent experience in County Agency. Accounting, Insurance, Paralegal experience may be transferable. Proficient in state specific Medicaid Eligibility Requirements & Application Process. Proficient in review of Medicaid Applications. Time and Priority Management Ability to travel to multi-sites within an identified region. We offer competitive compensation and benefit plans including: Vacation, sick and holiday pay Medical, Dental, Vision Insurance ST/LT Disability Insurance Tuition Reimbursement Life Insurance 401K We embrace diversity and are committed to fostering an inclusive workplace for all employees.