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Regional Medicaid Specialist

Company: Mission Point Healthcare Services
Location: Grand Rapids
Posted on: May 26, 2023

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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