Legacy Home Health Agency
San Antonio, Texas 78213, USA
We are hiring PAS Field Supervisors to conduct supervisory visits for our clients in their homes.
Legacy Home Health Agency is proud of our continuous service to our South Texas families for more than 20 years. Our compassionate care is built by the strong support from our exceptional staff. We need you to join our team!
Pay:
$20.00 - $25.00/hour
Apply if you:
*Enjoy Patient Interaction
*Want a non-traditional work environment
*Seek growth opportunities
Benefits:
Medical, Dental, Vision, and Life Insurance
401(k)
GENEROUS PTO Policy (including 6 paid holidays per year)
Tuition Reimbursement
Company tablet and phone provided for visits
Paid Training and Free Company Scrubsafter 90 days!
Education/Experience: You must qualify in one of the following categories:
be a licensed nurse (LVN)
have completed 60 college credit hours at an accredited college or university
Have one year experience in a supervisory role in a medical setting and 30 college credit hours
Have two years’ experience in a supervisory role in a medical setting
You must have reliable transportation and be able to use your personal vehicle to conduct field visits; Mileage reimbursement is provided.
Language requirements for this position are English/Spanish.
Duties and Responsibilities:
Conduct in-person supervisory visits in our clients residence.
Start your day in the office, then complete assigned schedule of visits received. End your day in the field!
Keep accurate and timely documentation.
Ensure services are provided to all clients in accordance with the established service plan.
Assist with the handling and investigation of grievances and complaints.
Hours:
Monday - Friday
8:00am - 5:00pm (some flexibility expected for later end time)
Rotating PAID on-call weekend schedule (once every 6 weeks)
¿Habla Español? ¡Aplica ya!
Apr 11, 2024
Full time
We are hiring PAS Field Supervisors to conduct supervisory visits for our clients in their homes.
Legacy Home Health Agency is proud of our continuous service to our South Texas families for more than 20 years. Our compassionate care is built by the strong support from our exceptional staff. We need you to join our team!
Pay:
$20.00 - $25.00/hour
Apply if you:
*Enjoy Patient Interaction
*Want a non-traditional work environment
*Seek growth opportunities
Benefits:
Medical, Dental, Vision, and Life Insurance
401(k)
GENEROUS PTO Policy (including 6 paid holidays per year)
Tuition Reimbursement
Company tablet and phone provided for visits
Paid Training and Free Company Scrubsafter 90 days!
Education/Experience: You must qualify in one of the following categories:
be a licensed nurse (LVN)
have completed 60 college credit hours at an accredited college or university
Have one year experience in a supervisory role in a medical setting and 30 college credit hours
Have two years’ experience in a supervisory role in a medical setting
You must have reliable transportation and be able to use your personal vehicle to conduct field visits; Mileage reimbursement is provided.
Language requirements for this position are English/Spanish.
Duties and Responsibilities:
Conduct in-person supervisory visits in our clients residence.
Start your day in the office, then complete assigned schedule of visits received. End your day in the field!
Keep accurate and timely documentation.
Ensure services are provided to all clients in accordance with the established service plan.
Assist with the handling and investigation of grievances and complaints.
Hours:
Monday - Friday
8:00am - 5:00pm (some flexibility expected for later end time)
Rotating PAID on-call weekend schedule (once every 6 weeks)
¿Habla Español? ¡Aplica ya!
Imagenet LLC is a premier healthcare technology company that has taken medical claims processing and document management to new levels of service, security and efficiency. Our core business is helping our clients reduce costs and increase productivity by providing efficient document imaging, data validation, adjudication and on demand retrieval of documents and data.
JOB OVERVIEW
We are seeking an experienced Healthcare Claims Director to oversee our claims processing operations and drive data-driven process improvements. This leadership role will manage a team of claims managers and analysts, ensure compliance, and leverage data analytics to enhance claims performance.
RESPONSIBILITIES
Provide strategic direction and operational oversight for healthcare claims processing across multiple lines of business
Manage a team of claims managers, analysts and supporting staff across multiple locations
Develop and implement policies, procedures and workflows for efficient claims adjudication
Monitor performance metrics and identify opportunities for process optimization
Leverage data analytics tools to analyze claims data, identify trends and generate actionable insights
Develop reporting dashboards and visualizations to share key metrics with leadership
Ensure adherence to regulatory compliance, coding guidelines and revenue cycle best practices
Collaborate with IT, clinical, and business teams on systems improvements and integrations
Manage relationships and resolve escalated issues with healthcare providers and payers
Mentor, coach and provide professional development for team members
Technical Skills/Knowledge
Bachelor's degree in healthcare administration, business or related field
7+ years of management experience in healthcare claims processing
Deep understanding of claims operations, revenue cycle management and compliance
Strong data analytics skills and experience using tools like Tableau, SQL, PowerBI
Proven ability to analyze data, synthesize insights and drive process improvements
Excellent communication, presentation and leadership abilities
Motivated team player with a customer-focused mindset
Job Type: Full-time
Experience:
claims or claims processing, managing: 7+ years (Required)
Work authorization:
United States (Required)
Job Type: Full-time
Pay $90,000-$100,000 per year
Benefits:
We offer a competitive compensation and benefits package commensurate with experience as well as PTO. This is an office-based position
Schedule:
8 hour shift
Day shift
Monday to Friday
Ability to commute/relocate:
Tampa, FL 33618: Reliably commute or planning to relocate before starting work (Required)
Experience:
7+ years of management experience in healthcare claims processing
Deep understanding of claims operations, revenue cycle management and compliance
Strong data analytics skills and experience using tools like Tableau, SQL, PowerBI
Work Location: In person
Apr 09, 2024
Full time
Imagenet LLC is a premier healthcare technology company that has taken medical claims processing and document management to new levels of service, security and efficiency. Our core business is helping our clients reduce costs and increase productivity by providing efficient document imaging, data validation, adjudication and on demand retrieval of documents and data.
JOB OVERVIEW
We are seeking an experienced Healthcare Claims Director to oversee our claims processing operations and drive data-driven process improvements. This leadership role will manage a team of claims managers and analysts, ensure compliance, and leverage data analytics to enhance claims performance.
RESPONSIBILITIES
Provide strategic direction and operational oversight for healthcare claims processing across multiple lines of business
Manage a team of claims managers, analysts and supporting staff across multiple locations
Develop and implement policies, procedures and workflows for efficient claims adjudication
Monitor performance metrics and identify opportunities for process optimization
Leverage data analytics tools to analyze claims data, identify trends and generate actionable insights
Develop reporting dashboards and visualizations to share key metrics with leadership
Ensure adherence to regulatory compliance, coding guidelines and revenue cycle best practices
Collaborate with IT, clinical, and business teams on systems improvements and integrations
Manage relationships and resolve escalated issues with healthcare providers and payers
Mentor, coach and provide professional development for team members
Technical Skills/Knowledge
Bachelor's degree in healthcare administration, business or related field
7+ years of management experience in healthcare claims processing
Deep understanding of claims operations, revenue cycle management and compliance
Strong data analytics skills and experience using tools like Tableau, SQL, PowerBI
Proven ability to analyze data, synthesize insights and drive process improvements
Excellent communication, presentation and leadership abilities
Motivated team player with a customer-focused mindset
Job Type: Full-time
Experience:
claims or claims processing, managing: 7+ years (Required)
Work authorization:
United States (Required)
Job Type: Full-time
Pay $90,000-$100,000 per year
Benefits:
We offer a competitive compensation and benefits package commensurate with experience as well as PTO. This is an office-based position
Schedule:
8 hour shift
Day shift
Monday to Friday
Ability to commute/relocate:
Tampa, FL 33618: Reliably commute or planning to relocate before starting work (Required)
Experience:
7+ years of management experience in healthcare claims processing
Deep understanding of claims operations, revenue cycle management and compliance
Strong data analytics skills and experience using tools like Tableau, SQL, PowerBI
Work Location: In person
Imagenet is a premier healthcare technology company that has taken medical claims processing and document management to new levels of service, security and efficiency. We are looking for Claims Examiners to join our rapidly growing team in Tampa. Experience is preferred but not necessary. Candidates with the right aptitude and desire to learn will be given the required training to be successful. We are excited for this limited opportunity to train candidates that have a phenomenal work ethic and want to learn a new trade. You will receive in-depth training on industry standards, coding, and metrics. Please apply if you exhibit the focus and desire to do great things!
We offer great benefits, flexible hours, and the opportunity for remote work for self-disciplined candidates who can perform well under limited supervision. Imagenet offers unlimited opportunities for candidates looking for upward mobility. Our leaders are always promoted from within and there is not a minimum employment time frame if you qualify for promotions. We appreciate referrals and always look to reward employees who help us grow.
MUST BE LOCAL TO TAMPA
Do not apply if you are not local to Tampa
This position is based in our Tampa office. However, employees who consistently meet performance metrics are eligible for a flexible work arrangement that allows working from home. To qualify, employees must:
Consistently meet or exceed all productivity and quality metrics for their role over a 3-month period
Demonstrate the ability to collaborate effectively and maintain strong communication with team members while working remotely
Have no active performance improvement plans or disciplinary issues
Once the above criteria are met, the employee may submit a request to work from home up to 2 days per week. Approval will be at the manager's discretion based on business needs and the employee's proven performance.
Any decrease in productivity or engagement may result in the flexible arrangement being discontinued.
We strive to provide flexibility where possible to employees who have demonstrated success in their role. This policy is subject to ongoing review and may be updated or discontinued based on business requirements.
Job Description
Analyze and adjudicate a variety of claim types to include facility, professional, inpatient and outpatient services
Follow claims adjudication rules to assure that all claims are adjudicated in accordance with CMS rules and regulations and our Client's internal criteria
Review different lines of business to include Medicare, Medicaid and Commercial services adherence to the contracts and timeliness guidelines
Authorize claim payments within established limits; otherwise forward to Claims Manager
Potentially process refunds appeals, disputes and adjustments (when applicable)
Identify process improvement opportunities within the claim department and recommend system enhancements
Handles any additional responsibility which may be assigned
Education : High School Diploma or equivalent required
Experience :
Preference for minimum of one-year experience working closely with healthcare claims or in a claims processing/adjudication environment
Open to training candidates without experience
Technical Skills / Knowledge:
Understanding of health claims processing/adjudication
Ability to perform basic to intermediate mathematical computation routines
Medical terminology strongly preferred
Understanding of ICD-9 & ICD-10
Basic MS office computer skills
Ability to work independently or within a team
Time management skills
Written and verbal communication skills
Attention to detail
Must be able to demonstrate sound decision-making skills
Salary: $15.00 - $18.00 per hour based on experience.
Job Type: Full-time
Benefits:
Dental insurance
Health insurance
Vision insurance
Performance Bonus
Referral Bonus
PTO
Schedule:
8 hour shift
Monday to Friday
Flexible schedule
Work Location: Hybrid remote in Tampa, FL 33618
Ability to commute/relocate:
Tampa, FL 33618: Reliably commute or planning to relocate before starting work (Required)
Apr 08, 2024
Full time
Imagenet is a premier healthcare technology company that has taken medical claims processing and document management to new levels of service, security and efficiency. We are looking for Claims Examiners to join our rapidly growing team in Tampa. Experience is preferred but not necessary. Candidates with the right aptitude and desire to learn will be given the required training to be successful. We are excited for this limited opportunity to train candidates that have a phenomenal work ethic and want to learn a new trade. You will receive in-depth training on industry standards, coding, and metrics. Please apply if you exhibit the focus and desire to do great things!
We offer great benefits, flexible hours, and the opportunity for remote work for self-disciplined candidates who can perform well under limited supervision. Imagenet offers unlimited opportunities for candidates looking for upward mobility. Our leaders are always promoted from within and there is not a minimum employment time frame if you qualify for promotions. We appreciate referrals and always look to reward employees who help us grow.
MUST BE LOCAL TO TAMPA
Do not apply if you are not local to Tampa
This position is based in our Tampa office. However, employees who consistently meet performance metrics are eligible for a flexible work arrangement that allows working from home. To qualify, employees must:
Consistently meet or exceed all productivity and quality metrics for their role over a 3-month period
Demonstrate the ability to collaborate effectively and maintain strong communication with team members while working remotely
Have no active performance improvement plans or disciplinary issues
Once the above criteria are met, the employee may submit a request to work from home up to 2 days per week. Approval will be at the manager's discretion based on business needs and the employee's proven performance.
Any decrease in productivity or engagement may result in the flexible arrangement being discontinued.
We strive to provide flexibility where possible to employees who have demonstrated success in their role. This policy is subject to ongoing review and may be updated or discontinued based on business requirements.
Job Description
Analyze and adjudicate a variety of claim types to include facility, professional, inpatient and outpatient services
Follow claims adjudication rules to assure that all claims are adjudicated in accordance with CMS rules and regulations and our Client's internal criteria
Review different lines of business to include Medicare, Medicaid and Commercial services adherence to the contracts and timeliness guidelines
Authorize claim payments within established limits; otherwise forward to Claims Manager
Potentially process refunds appeals, disputes and adjustments (when applicable)
Identify process improvement opportunities within the claim department and recommend system enhancements
Handles any additional responsibility which may be assigned
Education : High School Diploma or equivalent required
Experience :
Preference for minimum of one-year experience working closely with healthcare claims or in a claims processing/adjudication environment
Open to training candidates without experience
Technical Skills / Knowledge:
Understanding of health claims processing/adjudication
Ability to perform basic to intermediate mathematical computation routines
Medical terminology strongly preferred
Understanding of ICD-9 & ICD-10
Basic MS office computer skills
Ability to work independently or within a team
Time management skills
Written and verbal communication skills
Attention to detail
Must be able to demonstrate sound decision-making skills
Salary: $15.00 - $18.00 per hour based on experience.
Job Type: Full-time
Benefits:
Dental insurance
Health insurance
Vision insurance
Performance Bonus
Referral Bonus
PTO
Schedule:
8 hour shift
Monday to Friday
Flexible schedule
Work Location: Hybrid remote in Tampa, FL 33618
Ability to commute/relocate:
Tampa, FL 33618: Reliably commute or planning to relocate before starting work (Required)
Imagenet, LLC is seeking an experienced Quality Manager, Claims Processing to join our team. In this role, you will be responsible for overseeing the performance and quality of our claims processing department.
Responsibilities:
Develop and implement quality assurance policies, procedures, and standards for claims processing.
Monitor claims processing metrics such as productivity, accuracy, turnaround times, and customer satisfaction
Identify areas for improvement in claims processing and develop solutions
Conduct audits on a sample of processed claims to ensure adherence to regulations, guidelines, and quality standards
Analyze performance data, identify trends and root causes of defects, and suggest process improvements
Coach and mentor claims processing staff on performance, compliance, and career development
Create and manage quality assurance training programs for claims staff
Track quality standards and report on quality goals and progress to senior management
Requirements:
Previous claims processing quality management or related field preferred
5+ years of experience in claims processing, including 3+ years in a quality assurance role
Expert knowledge of claims processing procedures, quality standards, and regulatory requirements
Strong analytical and problem-solving skills
Ability to interpret data and generate detailed reports (daily/weekly/monthly) in graphs & presentations
Experience developing and conducting quality audits
Leadership skills with the ability to influence outcomes and drive change
Excellent communication and presentation abilities
This is an opportunity to oversee quality for a growing claims processing provider . If you have the required claims processing and quality assurance experience, please apply with your resume.
Apr 08, 2024
Full time
Imagenet, LLC is seeking an experienced Quality Manager, Claims Processing to join our team. In this role, you will be responsible for overseeing the performance and quality of our claims processing department.
Responsibilities:
Develop and implement quality assurance policies, procedures, and standards for claims processing.
Monitor claims processing metrics such as productivity, accuracy, turnaround times, and customer satisfaction
Identify areas for improvement in claims processing and develop solutions
Conduct audits on a sample of processed claims to ensure adherence to regulations, guidelines, and quality standards
Analyze performance data, identify trends and root causes of defects, and suggest process improvements
Coach and mentor claims processing staff on performance, compliance, and career development
Create and manage quality assurance training programs for claims staff
Track quality standards and report on quality goals and progress to senior management
Requirements:
Previous claims processing quality management or related field preferred
5+ years of experience in claims processing, including 3+ years in a quality assurance role
Expert knowledge of claims processing procedures, quality standards, and regulatory requirements
Strong analytical and problem-solving skills
Ability to interpret data and generate detailed reports (daily/weekly/monthly) in graphs & presentations
Experience developing and conducting quality audits
Leadership skills with the ability to influence outcomes and drive change
Excellent communication and presentation abilities
This is an opportunity to oversee quality for a growing claims processing provider . If you have the required claims processing and quality assurance experience, please apply with your resume.
We are seeking a detail-oriented and experienced Medical Claims Auditor to join our team. As a Medical Claims Auditor, you will be responsible for reviewing and auditing medical claims to ensure accuracy, compliance with regulations, and adherence to company policies and procedures. You will work closely with the claims processing team to identify discrepancies, resolve issues, and improve overall claims accuracy.
Key Responsibilities
Conduct audits of medical claims to verify accuracy, completeness, and compliance with regulatory requirements.
Review claim documentation, including medical records and billing codes, to ensure proper coding and billing practices.
Identify errors, discrepancies, and potential fraud or abuse in claims submissions.
Investigate and resolve discrepancies through communication with internal departments, and clients.
Collaborate with the claims processing team to implement process improvements and ensure consistent adherence to company policies and procedures.
Prepare audit reports detailing findings, recommendations, and corrective actions taken.
Stay current with industry regulations, coding guidelines, and best practices related to medical claims processing and auditing.
Qualifications
Bachelor's degree or equivalent experience in healthcare administration, business administration, or a related field.
Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification preferred.
Minimum of 5 years of experience in medical claims processing, billing, or auditing.
Strong understanding of medical terminology, ICD-10, CPT, and HCPCS coding systems.
Knowledge of healthcare regulations, including HIPAA, Medicare, and Medicaid guidelines.
Excellent analytical and problem-solving skills with a keen attention to detail.
Effective communication skills, both verbal and written, with the ability to communicate complex information clearly and concisely.
Proficiency in Microsoft Office applications, especially Excel, and experience with claims processing software preferred.
Apr 08, 2024
Full time
We are seeking a detail-oriented and experienced Medical Claims Auditor to join our team. As a Medical Claims Auditor, you will be responsible for reviewing and auditing medical claims to ensure accuracy, compliance with regulations, and adherence to company policies and procedures. You will work closely with the claims processing team to identify discrepancies, resolve issues, and improve overall claims accuracy.
Key Responsibilities
Conduct audits of medical claims to verify accuracy, completeness, and compliance with regulatory requirements.
Review claim documentation, including medical records and billing codes, to ensure proper coding and billing practices.
Identify errors, discrepancies, and potential fraud or abuse in claims submissions.
Investigate and resolve discrepancies through communication with internal departments, and clients.
Collaborate with the claims processing team to implement process improvements and ensure consistent adherence to company policies and procedures.
Prepare audit reports detailing findings, recommendations, and corrective actions taken.
Stay current with industry regulations, coding guidelines, and best practices related to medical claims processing and auditing.
Qualifications
Bachelor's degree or equivalent experience in healthcare administration, business administration, or a related field.
Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification preferred.
Minimum of 5 years of experience in medical claims processing, billing, or auditing.
Strong understanding of medical terminology, ICD-10, CPT, and HCPCS coding systems.
Knowledge of healthcare regulations, including HIPAA, Medicare, and Medicaid guidelines.
Excellent analytical and problem-solving skills with a keen attention to detail.
Effective communication skills, both verbal and written, with the ability to communicate complex information clearly and concisely.
Proficiency in Microsoft Office applications, especially Excel, and experience with claims processing software preferred.
Imagenet LLC is a premier healthcare technology company that has taken medical claims processing and document management to new levels of service, security and efficiency. Our core business is helping our clients reduce costs and increase productivity by providing efficient document imaging, data validation, adjudication and on demand retrieval of documents and data.
JOB OVERVIEW
Ensure compliance will all corporate and departmental standards. Meet with employees on a regular basis to discuss performance and quality. Report on Key Performance Metrics (KPIs) to the Executive Director of Claims and the Director of Operations to ensure adequate resources and technology are in place. Develop and implement departmental standards and expectations. Analyze and process a variety of claim files to ensure the execution of standardized claim protocol and claim handling.
RESPONSIBILITIES
Oversee the claims adjudication process to assure that the examiners are following all CMS rules and regulations in conjunction with the insurance company guidelines
Ensure that the department practices meet or exceed the client’s processing standards, procedures and service level agreements
Responsible for new Claims Analyst training and auditing of trainee claim processing
Review Medicare services for appropriateness of charges and will apply pre-existing guidelines during claims processing;
Pend claims and order Medical records for review and investigation of possible gross misrepresentation
Authorize claim payments within established limits; otherwise forward to Claims Analyst 2
Oversee and provide secondary review of pending cases and Medical Records ordered by Claims Analyst 1 for appropriate processing;
Process refunds and letters of dual coverage (when applicable);
Must be knowledgeable in CPT-4, ICD-9 and be familiar with medical terminology;
Identify process improvement opportunities within the claim department and recommend system enhancements
Handles any additional responsibility which may be assigned
Technical Skills/Knowledge
Health claims processing
Basic to intermediate math
Medical terminology; ICD-9 & ICD-10
MS Office
Ability to work independently or within a team
Time management
Written and verbal communication
Attention to detail
Must be able to demonstrate sound decision-making
Must be local to Tampa area and work out of the Tampa office
Job Type: Full-time
Experience:
claims or claims processing, managing: 3 years (Required)
Work authorization:
United States (Required)
Job Type: Full-time
Pay: $60,000.00 - $80,000.00 per year
Benefits:
Disability insurance
Schedule:
8 hour shift
Day shift
Monday to Friday
Ability to commute/relocate:
Tampa, FL 33618: Reliably commute or planning to relocate before starting work (Required)
Experience:
Medical billing: 5 years (Required)
Management: 5 years (Required)
Work Location: In person
Apr 08, 2024
Full time
Imagenet LLC is a premier healthcare technology company that has taken medical claims processing and document management to new levels of service, security and efficiency. Our core business is helping our clients reduce costs and increase productivity by providing efficient document imaging, data validation, adjudication and on demand retrieval of documents and data.
JOB OVERVIEW
Ensure compliance will all corporate and departmental standards. Meet with employees on a regular basis to discuss performance and quality. Report on Key Performance Metrics (KPIs) to the Executive Director of Claims and the Director of Operations to ensure adequate resources and technology are in place. Develop and implement departmental standards and expectations. Analyze and process a variety of claim files to ensure the execution of standardized claim protocol and claim handling.
RESPONSIBILITIES
Oversee the claims adjudication process to assure that the examiners are following all CMS rules and regulations in conjunction with the insurance company guidelines
Ensure that the department practices meet or exceed the client’s processing standards, procedures and service level agreements
Responsible for new Claims Analyst training and auditing of trainee claim processing
Review Medicare services for appropriateness of charges and will apply pre-existing guidelines during claims processing;
Pend claims and order Medical records for review and investigation of possible gross misrepresentation
Authorize claim payments within established limits; otherwise forward to Claims Analyst 2
Oversee and provide secondary review of pending cases and Medical Records ordered by Claims Analyst 1 for appropriate processing;
Process refunds and letters of dual coverage (when applicable);
Must be knowledgeable in CPT-4, ICD-9 and be familiar with medical terminology;
Identify process improvement opportunities within the claim department and recommend system enhancements
Handles any additional responsibility which may be assigned
Technical Skills/Knowledge
Health claims processing
Basic to intermediate math
Medical terminology; ICD-9 & ICD-10
MS Office
Ability to work independently or within a team
Time management
Written and verbal communication
Attention to detail
Must be able to demonstrate sound decision-making
Must be local to Tampa area and work out of the Tampa office
Job Type: Full-time
Experience:
claims or claims processing, managing: 3 years (Required)
Work authorization:
United States (Required)
Job Type: Full-time
Pay: $60,000.00 - $80,000.00 per year
Benefits:
Disability insurance
Schedule:
8 hour shift
Day shift
Monday to Friday
Ability to commute/relocate:
Tampa, FL 33618: Reliably commute or planning to relocate before starting work (Required)
Experience:
Medical billing: 5 years (Required)
Management: 5 years (Required)
Work Location: In person
Senior Connection Center, Inc.
Tampa, FL 33619, USA
General Description
This is a responsible non-exempt position on the staff of Senior Connection Center where exercising good judgment in evaluating situations and making decisions is very important. Adept at interpreting and explaining complex information about Long Term Care (LTC), this professional position shall perform Long Term Care Medicaid service related activities which include intake, screening, potentially eligible individuals for enrollment and/or triage duties which inform eligible or potentially eligible individuals, their families and/or educating community partners about Medicaid covered services and how to obtain them.
Staff position is 100 percent (100%) Medicaid related and shall perform some or all of the following Aging and Disability Resource Center (ADRC) activities:
Responsibilities
Accepts referrals from the Elder Helpline, as well as other resources for intake and screening as assigned by the Long Term Care Services (LTCS) Coordinator and/or Manager.
Refers individuals in need of community resource assistance to the Elder Helpline.
Determines the individual’s needs and screen for potential eligibility for Medicaid-related services utilizing a standardized screening instrument.
Provides efficient, timely and consumer friendly services to facilitate the eligibility application and review process;
Verifies an individual’s current Medicaid eligibility status for purposes of the Medicaid eligibility process.
Explains Medicaid eligibility rules and the Medicaid eligibility process to prospective applicants.
Conducts comprehensive screening on Medicaid probable individuals on the Assessed Priority Consumer List (APCL)
Inputs client assessments into CIRTS (Client Information and Registration Tracking System).
Posts information in the enrollment and termination screens of CIRTS to update the APCL as needed.
Provides necessary forms and package all forms in preparation for Medicaid eligibility determination.
Gathers information related to the application and eligibility determination for an individual, including resource information and third party liability information, as a prelude to submitting a formal Medicaid application.
Assists individual in collecting and gathering required information and documents for the Medicaid application, this assistance may be provided in the individual’s home. The activity includes assisting the potential applicant, as a secondary resource to family members and care providers, in gathering information and completing an application for Medicaid benefits.
Refers the individual to the local (or ADRC collocated) Department of Children and Families/Automated Community Connection to Economic Self-Sufficiency (DCF/ACCESS) staff to make application for Medicaid benefits. Coordinate with these staff regarding eligibility matters for Medicaid eligible or potentially eligible individuals.
Assists in obtaining the Physical Referral form (3008) for Medicaid Waiver probable individuals and coordinate with CARES (Comprehensive Assessment and Review for Long Term Care Services) staff for determination of functional eligibility.
Collects, reviews and maintains accurate Medicaid eligibility determination tracking data to ensure completeness, accuracy and timeline.
Tracks Medicaid applications through the eligibility process.
Contacts individuals on the APCL as required to update information and screen for Medicaid eligibility.
Participates in meetings with DCF, CARES and other entities as appropriate to facilitate and enhance the Medicaid eligibility determination process.
Acts as a consumer advocate by coordinating with CARES and DCF/ACCESS staff to resolve in a timely manner any eligibly issues that arise during the Medicaid eligibility determination process.
Standardizes and makes consistent outreach efforts to ensure public awareness of Medicaid programs and services and how to access them.
Develops, compiles and distributes materials to inform individuals about the Medicaid programs, as well as how and where to obtain those benefits. Note: This activity does not include compiling information already available through the Medicaid agency or Department of Elder Affairs.
Builds relationships with and educate service providers, professional entities and other professionals, such as hospital discharge planners and nursing home social workers, to facilitate referrals and increase awareness of Medicaid resources.
Regularly meets with and training ADRC access points to increase awareness of Medicaid resources to individuals and target populations.
Performs other Medicaid-related duties as assigned; which may include counseling disaster victims about Medicaid programs options and the eligibility process.
Performs other related duties as required.
Minimum Education and Experience
Minimum education and related experience:
Bachelor’s Degree; or
Associate’s Degree and two (2) years of experience; or
High School Graduate or Equivalent and four (4) years of experience
Successful completion of applicable background screening required.
Any exceptions to the minimum requirements must be approved by the President and CEO.
Required Skills and Knowledge
Ability to communicate well, orally and in writing.
Ability to research topics related to services for older adults (funding, program
design, etc.), analyze data and provide written and/or oral reports as required.
Ability to establish and maintain effective working relationships with others.
Basic skill level and knowledge of MS Office Suite including MS Word, Excel,
PowerPoint and database creation and maintenance either in Excel or
Access.
Physical Requirements
Ability to work under stressful situations.
Pleasant and clearly understandable telephone voice.
Ability to lift and carry at least 10 pounds.
Ability to operate a computer and other office equipment.
Ability to sit at a desk for more than one hour at a time.
Ability to bend and stoop in order to file and shelve.
Apr 01, 2024
Full time
General Description
This is a responsible non-exempt position on the staff of Senior Connection Center where exercising good judgment in evaluating situations and making decisions is very important. Adept at interpreting and explaining complex information about Long Term Care (LTC), this professional position shall perform Long Term Care Medicaid service related activities which include intake, screening, potentially eligible individuals for enrollment and/or triage duties which inform eligible or potentially eligible individuals, their families and/or educating community partners about Medicaid covered services and how to obtain them.
Staff position is 100 percent (100%) Medicaid related and shall perform some or all of the following Aging and Disability Resource Center (ADRC) activities:
Responsibilities
Accepts referrals from the Elder Helpline, as well as other resources for intake and screening as assigned by the Long Term Care Services (LTCS) Coordinator and/or Manager.
Refers individuals in need of community resource assistance to the Elder Helpline.
Determines the individual’s needs and screen for potential eligibility for Medicaid-related services utilizing a standardized screening instrument.
Provides efficient, timely and consumer friendly services to facilitate the eligibility application and review process;
Verifies an individual’s current Medicaid eligibility status for purposes of the Medicaid eligibility process.
Explains Medicaid eligibility rules and the Medicaid eligibility process to prospective applicants.
Conducts comprehensive screening on Medicaid probable individuals on the Assessed Priority Consumer List (APCL)
Inputs client assessments into CIRTS (Client Information and Registration Tracking System).
Posts information in the enrollment and termination screens of CIRTS to update the APCL as needed.
Provides necessary forms and package all forms in preparation for Medicaid eligibility determination.
Gathers information related to the application and eligibility determination for an individual, including resource information and third party liability information, as a prelude to submitting a formal Medicaid application.
Assists individual in collecting and gathering required information and documents for the Medicaid application, this assistance may be provided in the individual’s home. The activity includes assisting the potential applicant, as a secondary resource to family members and care providers, in gathering information and completing an application for Medicaid benefits.
Refers the individual to the local (or ADRC collocated) Department of Children and Families/Automated Community Connection to Economic Self-Sufficiency (DCF/ACCESS) staff to make application for Medicaid benefits. Coordinate with these staff regarding eligibility matters for Medicaid eligible or potentially eligible individuals.
Assists in obtaining the Physical Referral form (3008) for Medicaid Waiver probable individuals and coordinate with CARES (Comprehensive Assessment and Review for Long Term Care Services) staff for determination of functional eligibility.
Collects, reviews and maintains accurate Medicaid eligibility determination tracking data to ensure completeness, accuracy and timeline.
Tracks Medicaid applications through the eligibility process.
Contacts individuals on the APCL as required to update information and screen for Medicaid eligibility.
Participates in meetings with DCF, CARES and other entities as appropriate to facilitate and enhance the Medicaid eligibility determination process.
Acts as a consumer advocate by coordinating with CARES and DCF/ACCESS staff to resolve in a timely manner any eligibly issues that arise during the Medicaid eligibility determination process.
Standardizes and makes consistent outreach efforts to ensure public awareness of Medicaid programs and services and how to access them.
Develops, compiles and distributes materials to inform individuals about the Medicaid programs, as well as how and where to obtain those benefits. Note: This activity does not include compiling information already available through the Medicaid agency or Department of Elder Affairs.
Builds relationships with and educate service providers, professional entities and other professionals, such as hospital discharge planners and nursing home social workers, to facilitate referrals and increase awareness of Medicaid resources.
Regularly meets with and training ADRC access points to increase awareness of Medicaid resources to individuals and target populations.
Performs other Medicaid-related duties as assigned; which may include counseling disaster victims about Medicaid programs options and the eligibility process.
Performs other related duties as required.
Minimum Education and Experience
Minimum education and related experience:
Bachelor’s Degree; or
Associate’s Degree and two (2) years of experience; or
High School Graduate or Equivalent and four (4) years of experience
Successful completion of applicable background screening required.
Any exceptions to the minimum requirements must be approved by the President and CEO.
Required Skills and Knowledge
Ability to communicate well, orally and in writing.
Ability to research topics related to services for older adults (funding, program
design, etc.), analyze data and provide written and/or oral reports as required.
Ability to establish and maintain effective working relationships with others.
Basic skill level and knowledge of MS Office Suite including MS Word, Excel,
PowerPoint and database creation and maintenance either in Excel or
Access.
Physical Requirements
Ability to work under stressful situations.
Pleasant and clearly understandable telephone voice.
Ability to lift and carry at least 10 pounds.
Ability to operate a computer and other office equipment.
Ability to sit at a desk for more than one hour at a time.
Ability to bend and stoop in order to file and shelve.