Regional Medicaid Specialist
Company: Mission Point Healthcare Services
Location: Grand Rapids
Posted on: May 26, 2023
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Job Description:
Position Summary:The Regional Medicaid Specialists is
responsible for executing regional coverage plans and managing
resources to ensure that Medicaid processes are standardized across
the region. This role acts as a liaison and subject matter expert
Medicaid eligibility, NOEs, and Medicaid claims between the company
and state agencies.Principal Duties and Responsibilities: Execute
regional coverage plans and manage resources to ensure Medicaid
processes are standardized at each location across the region.
Responsible for managing the contracts between Mission Point
Healthcare Services and the State, if applicable, regarding
caseworkers employed by the state but funded by Mission Point.
Responsible for regular, periodic reporting to the VP Operations,
RDOs on key trends/metrics in the financial operations on Medicaid
for assigned facilities. Attends regional and divisional level
operations meetings at the request of the VP Operations and RDOs.
Consistently uses Medicaid Pending Logs, PCC Collections Module,
and other available reports in the monitoring, tracking, reporting,
documenting, and escalation process. Consults with business unit
operators on process improvements. Ensures the MA process is
completed accurately and submitted in a timely manner. Tracks and
maintains MA Process activities on appropriate tools. Corresponds
with the Department of Public Welfare (DPW) on the status of
pending applications. Attends and participates in scheduled
in-service programs and staff meetings. Attend weekly Medicaid
meeting with the Administrator and Business Office Manager to
review specifics on all pending accounts. Audit and follow-up on
Medicaid applications/patients as needed to secure case approval.
Maintains the highest level of confidentiality of necessary
information. Performs other projects or duties as assigned.Mission
Points Expectations of all Employees: Adheres to all Mission Point
Policies and Procedures. Conducts self in a manner consistent with
Mission Points' Core Values at all times. Maintains a positive and
respectful attitude with all word-related contacts. Consistently
reports to work on time and prepared to perform the duties of the
position. Meets productivity standards and performs duties as
workload necessitates. Maintains the privacy of all patient
information and company proprietary information. Treat residents,
family members, visitors, and team members with respect and
dignity. Able to safely perform the essential functions of the job
with or without reasonable accommodation. Must maintain an active
license or the required certification(s) (if required by the
job).Required/Desired Qualifications:Education, Training, and
Experience: High School Diploma or equivalent plus additional
training leading to a degree. 12+ years experience with healthcare
business office functions and / or patient accounts.Specific
skills, knowledge, and abilities: Excellent organizational skills
and attention to detail. Excellent written and verbal communication
skills. Ability to work independently and collaboratively. Must
have working knowledge of MS Office suite of applications, Visio
and scheduling software.
Keywords: Mission Point Healthcare Services, Grand Rapids , Regional Medicaid Specialist, Other , Grand Rapids, Michigan
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