The Medicaid and Revenue Cycle Supervisor:

• Provides and directs the Medicaid application process for potential participants, including application completion and submission, assisting applicants with gathering and processing verification items, and coordination with DCF case managers, tracking and follow-up of application.
• Manages current participants Medicaid recertifications to ensure timely submission of the CSR.
• Reviews monthly revenue cycle for current participants enrolled in the PACE programs and provides monthly reports on current eligibility and lost revenue.
• Responsible for submission of AHCA complaints for non-payment issues and tracks the resolution in the FLMMIS system.
• Represents the programs as the primary liaison with DCF and AHCA for processing and payment issues.
• Ensures timely response for Medicaid Specialists in scheduling home visits and gathering of documentation required for the application.
• Maintains/utilizes Medicaid tracking database to measure efficiency of the internal and external Medicaid approval process.
• Provides documentation in the EMR as necessary.
• Prepares a variety of periodic and special reports, which may require gathering data from several sources, compiling such data, and arranging it into proper format.
• Supports PACE finance department in validation of Medicaid payments and revenue cycle as needed and requested.
• Completes and records initial and annual verifications of participants.
• Maintains and updates participant shared payments for Assisted Living Facilities (ALF) and LTC
• Maintains professional affiliations and any required.
• Performs other duties as

Qualifications and Requirements:

• Associate’s degree or equivalent experience in customer service in a human services environment, business, or comparable education and experience required.
• Thorough understanding of DCF, Medicaid, and Social Security processes
• Extensive knowledge of community resources available to seniors and their families
• Ability to effectively represent the program to participants, families, outside agencies, community groups, community professionals and the general public.
• 1 year experience working with the frail and/or elderly populations required.
• Experience working with an Electronic Health Record preferred.
• Must submit to and pass a pre-employment drug/alcohol screening and criminal background check.
• Must have a current driver’s license and driving record must be in compliance with company.
• Operates in full compliance with all applicable federal, state and local fire, health, safety, sanitation, Emergency procedures and other Standards prescribed in law or regulations.

Empath Health values diversity as it strengthens our community and care. We embrace the diversity of cultures, thoughts, beliefs and traditions of our employees, volunteers and people we are honored to serve across our network. Our diverse staff reflects our community and each day, we work to be respectful, sensitive and competent with each other and those in our care. In every journey, we are dedicated to achieving comfort, dignity and exceptional care. Those of all backgrounds are welcome and encouraged to apply with us or seek our care and services.
Our commitment to patient, client, staff and volunteer safety is a cornerstone of a High Reliability Organization with a focus on zero harm. Participation in the seasonal influenza and COVID-19 program is a condition of employment and a requirement for all Empath Health employees.

Providing compassionate, full life care is an honor we take seriously at Empath Health. Join our team and make a positive impact in the community!