PTO & NYS

Sick Leave Tuition Assistance Program And Much More! 8am-4pm Monday-Friday $23.15

$30.86/hr
depending on experience

Summary:

The Medicaid/Insurance Specialist is responsible for working with patients and families referred to or admitted to Hospice Buffalo who are deemed potentially eligible for Medicaid or other financial assistance. Oversight of all admissions to program for Medicaid and Insurance eligibility for Department of Health reporting and billing purposes.

Essential Duties and Responsibilities:

Coordinates with team social workers in regard to the completion of financial assessments for all patients in need of Medicaid Assistance. Coordinates the process from submission to approval for all patients seeking Medicaid. Monitors all patients within program for Medicaid eligibility to be added to patient's chart for DOH reporting requirements. Works with clinical teams to review who is eligible for Medicaid and submit necessary communication to outside agencies for non-covered services per Department of Health. Ensures all levels of compliance with programs and all regulatory agencies (Medicare, Medicaid, third party payers, state and federal regulators). Effectively communicates Hospice philosophy to internal and external customers and participates in Agency professional development activities. Prepares reports and documentation as required. Communicates with employees, management, and outside contacts in a professional manner. Conforms with and abides by all policies and procedures.

Non-Essential Duties and Responsibilities:

Expected to perform additional duties.

Qualifications:

Education/Certification Minimum of Associates degree from an accredited university or college. Experience can be in lieu of degree. Current Notary Public Certification a plus OR willing to obtain. Experience Experience in case management. Working knowledge of the Medicaid and Insurance eligibility requirements and process. Experience working with social services agencies. Medical Coding experience a plus.

Values/Success Factors:

Excellence

Demonstrates the highest quality of work. Compassion
Treats internal and external customers with empathy and respect. Service
Attends to the needs and best interests of internal and external customers. Teamwork
Supports effective collaboration and communication in achieving common goals. Innovation
Offers suggestions for improvement and accepts creative ideas and concepts. Integrity
Maintains ethical, moral, and operational standards and adheres to corporate compliance standards as defined in the Corporate Compliance Plan.

Skills/Abilities:

Possess critical thinking skills, proficiency in organizing resources and establishing priorities with strong interpersonal and communication skills. Ability to plan and meet both short and long term goals. Working knowledge of Microsoft Office such as Word, Excel, PowerPoint, Outlook, and Navigation of internet. Working knowledge of eMedNY. Excellent oral and written communication skills. Excellent analytical and decision making skills. Ability to use independent judgment and work effectively with little or no direction. The ability and eagerness to promote a team environment by working in a cooperative and collegial manner with others to accomplish organizational goals and objectives. Must be able to handle diverse work problems on a daily basis with the ability to resolve problems and handle conflict as part of a team.

Physical Demands:

Position requires sitting, standing, bending and reaching along with a normal range of hearing and vision. Must be able to negotiate stairs, walkways, driveways, and other environmental objects while out on appointments, in patient homes, or visiting facilities. Must be free of communicable diseases. Must be able to operate standard office equipment such as computer, mobile device, phone, copier, scanner, printer, or related items.

Environmental Conditions:

May be called upon to work beyond the normal workday. May experience eye and repetitive motion strain from work on computer. Exposure to variable conditions in patient homes. May be subject to wet/slippery floors. 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