Job Description - Medicaid Specialist (2412304) Job Purpose: Directs and coordinates administrative and financial services which may include office, clerical, human resources support and supportive services. Familiar with medical financial concepts, practices and procedures. Relies on experience and judgment to plan and accomplish goals.
Job Classification Salary Range: $22.00 - $30.00
Key Responsibilities: Primary contact for partners, patients/residents, and family members.Discusses and educates family members on various services offered by the nursing home and methods of payment for those services including but not limited to Medicare, Medicaid, insurance and private pay.Verifies accuracy of patient information and completeness of admission file.Updates/maintains accurate daily census.Responsible for accurately reporting daily nursing hours.Makes daily deposits and records in a timely manner; reconciles facility petty cash.Assists with Medicaid pending procedures including assistance with the Medicaid application.Performs Human Resources, Recruiting and Payroll functions.Distributes funds and records transactions from Patient Trust fund and facility petty cash.Prepares transfer of expense form.Completes new vendor process and ensures all vendors are contracted with PruittHealth.Assists with month end and year end processes and procedures.Follows all company policies and procedures, state and federal laws and regulations and is charged with reporting violations to the appropriate supervisor.Knowledge, Skills, Abilities: Participate in center/agency surveys (Licensure / JCAHO) and any subsequently required reports.Attend and participate in continuing educational programs to keep abreast of changes in your field as well as to maintain current license/certification, as required.Attend and participate in mandatory in-services.Honor patients/residents' rights to fair and equitable treatment, self-determination, individuality, privacy, property and civil rights, including the right to wage complaints.Comply with corporate compliance program.Report job-related functions/tasks that involve occupational hazards including exposure to blood and body fluids and others as necessary.Follow established safety regulations, to include fire protection & prevention, smoking regulations, infection control, etc.Follow established safety procedures when performing tasks and/or working with equipment.Perform other related duties as necessary and as directed by supervisor.Excellent communication and organizational skills. Proficient in Excel, Word, and e-mail.Proven ability to work unsupervised and to prioritize and manage multiple assignments.Remain in consistent contact with the Central Team to ensure seamless operational transparency to the patients and their families.Takes initiative and manages their own daily processes. Certain degree of flexibility and latitude will be required.Keeps supervisor informed of daily activities and issues. Proposes solutions to all issues.Carries out all duties with a "Commitment to Caring" and in accordance with the company's mission, vision, and philosophy.Maintains confidentiality of company information.Excellent knowledge of Microsoft Office applications and ability to learn enterprise software including PeopleSoft and Healthcare Billing Applications.Strong work ethic required. Ability to work in fast-paced environment.Good organization skills. Attention to detail is essential.Qualifications Minimum Education Required: High School diploma or equivalent required.
Minimum Experience Required: Two (2) to four (4) years' experience in Healthcare Administration or related field required.
Minimum Licensure/Certification Required by Law: None.
Additional Qualifications (Preferred qualifications): Billing and Financial Experience preferred.
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