Medicaid Benefits Specialist

Description

Purpose

To work as a part of the finance and Self-direction teams, with a common goal of putting people first. Your primary role will be to assist the people AIM serves in maintaining Medicaid coverage, as well as other benefits. In the event of lapsed or improper coverage, you will work directly with the person and their team to provide necessary documentation, navigate benefit requirements, and regain/maintain coverage.

Status: Non-Exempt

Qualifications

· Associates degree or equivalent experience required, Bachelor’s degree preferred.

· Demonstrated knowledge of Medicaid enrollment.

· Strong communication skills.

· Effective time management skills.

· Strong organizational skills with a keen ability to prioritize and multi-task. Detail oriented.

· Edits work for spelling and grammar, presents numerical data effectively, and is able to read and interpret written information.

· Demonstrates accuracy and thoroughness and monitors own work to ensure quality.

· Proficiency in Microsoft Word and Excel.

· Adherence to Agency policies and procedures.

· Valid NYS Drivers’ License, acceptable to Agency insurance standards preferred. Maintain valid insurance and provide insurance card if you use your own vehicle.

Reports To: Director of Finance or designee

Essential Functions

· Identify lapses in participant eligibility using daily reports from eVero, Millin, Choices, and other systems.

· Work directly with the participant and their support team to address and educate them on eligibility issues. Follow up with the team until the issue is resolved.

· Process denied billing through Millin, once eligibility issues have been resolved.

· Reach out to teams prior to Medicaid recertification date to make sure they are aware of the

importance of the accurate and timely submission of their paperwork.

· Build relationships with county Medicaid offices across all regions AIM provides services in to assist with resolving outstanding eligibility issues.

· Build relationships with the participants and their teams, to better assist with their benefits.

· Ensure all demographic information is listed properly in eVero and Millin to match each participant’s Medicaid profile.

· Directly assist the person with their benefits application(s), when necessary.

· Any and all related duties as assigned by supervisor.

Requirements

 Physical/Cognitive Requirements:

· Ability to maintain a high level of professionalism and confidentiality.

· Ability to remain calm in stressful or demanding situations.

· Sitting and/or computer use/writing for extended periods of time.

· Ability to perform multiple tasks.

· Bending, reaching, pushing, and pulling as needed in the workplace.