Our Company:Overview:Responsibilities:

• Verifies prior to admission, the individual is eligible for Medicaid and has some type of active Medicaid based on referral packet.
• Oversees completion of all Admission paperwork (found on Central Intake Shared Drive)
• Completes Medicaid application ON THE DAY OF ADMISSION regardless of the current status to ensure Medicaid continues and is the correct coverage for the specific program.
• Faxes application and maintains verification of transmission
• Verifies prior to admission, if the individual is eligible for Social Security Benefits if current benefits received do not exceed maximum community SSI stipend. Completed application for SSI benefits if qualifies.
• Prior to admission ensures that all the individual's resources are accounted for such as Burial Trust, ARC Trusts, life insurance
• Responsible for entry of benefits and personal spending on Room and Board Agreements. Printing of room and food documents for signature.
• Sends PAC form attaching copies of signed room and food documents to Central Intake
• Responsible for ensuring all new admission paperwork is completed which includes: ALL ADMISSION DOCUMENTS listed on attached forms Submits documentation concerning Representative Payee to Client Trust Fund
• Responsible for working with Client Trust Fund Coordinator at the Austin
• Business Center to set up RFMS Account
• Assure individuals who qualify are enrolled with right Medicare Part D provider
• Completes PAC form for new admission and submits to Central Intake to include PAC required information as well as a copy of current IDRC and IPC as appropriate. One form can be used for submission of all documents.
• NEW ADMISSIONS CENTRAL INTAKE
• Enters admission information in required state systems
• Enters admission information into Interactant
• Enters correct Level of Need into Interactant
• Ensures Purpose Code 2 entered by Local Authority matches Interactant
• Enters Service Authorization and Level of Need begin and end dates are entered into Interactant
• Completion of Room and Board Templates for any shared household expenses Enters Applied Income and Room and Board into Interactant as monthly reoccurring charge
• Completes initial admission entry into Task Master Pro
• NEW ADMISSIONS AUSTIN BUSINESS CENTER
• Ensures all daily revenue drops correctly and new admission information matches reported census in Revenue Workbook
• Opens and Assigns RFMS account numbers for benefit direct deposits
• On-Going Verification OPERATIONS
• Checks and Responds to Quickbase assignments concerning issues with Medicaid Eligibility or Service Authorization issues
• Completes Medicaid Redetermination for each individual annually or as needed
• Files Medicaid Appeals when required within 30-day time frame of decisions
• Notifies Medicaid or Social Security of any changes in benefits and wages Completes Redetermination for Food Stamps as required
• Updates Room and Board Templates with changes in food stamps or benefits, prints for signatures. Completes PAC form for submission of all annual and revised Room and Board Agreements to Central Intake
• Ensures that all individuals remain eligible for all benefits at all times while they are receiving services
• Ensures all annual IDRCs and IPCs are completed and submitted timely along with PAC form to Central Intake.
• Communicates to Business Manager all CHANGES to LON based on submitted/approved IDRCs
• Reviews Quickbase for utilization issues requiring IPC revisions in the waiver. Ensures needed revisions are completed timely and prepares PAC forms for submission of all revisions to Central Intake.
• Reviews RFMS K-2 report in Quickbase to ensure resources are within Medicaid Limits and ensures planned spending occurs timely (before end of the month)
• Notifies Social Security Administration of any ongoing/future income changes
• Assure any lump sums are entitled to that person and spent down accordingly
• Completes annual SSA Income report
• Monitor, Request, and Assure Room & Board is received for non-payee individuals to include completion of monthly invoices for self-pay and CLIAB in those cases where EduCare is not the Representative Payee.
• Change Medicaid providers to assure physician needs are covered under the right group for that area/main PCP.
• ONGOING VERIFICATION CENTRAL INTAKE
• Runs monthly MESAV by the 4th day of the month
• Uploads information on any ineligibility reports to Quickbase
• Uploads Utilization report to Quickbase Uploads 2-K report to Quickbase
• Uploads Unbillable Report issues monthly into Quickbase
• To identify:
• Expired Medicaid
• Expiring IDRCs
• Expiring IPCs IPC revision needs Client Holds.

 Spend Down needs
o Create Quickbase record for all issues found
o Sent to Business()ffice Managers/Client Benefit Coordinators for correction
o Enters ALL on going service authorizations into the State Systems, reviewing to ensure basic services are present on all plans
o Enters ALL on going service authorizations into Interactant
o Ensures all Data Entry processes to completion in state systems
o Enters ALL changes for Room and Food Agreements into Interactant

• Notifies operations of all inaction with regards to 2K report prior to end of month Updates all Applied Income or Room and Board charge changes in interactant as reoccurring charge
• ONGOING VERIFICATION AUSTIN BUSINESS CENTER

o Completes and sends to Central Intake Unbillable Reports for those items that cannot be entered into CARE when billing is complete for upload into Quickbase. Sends monthly Denial Reports to operations for any billing denied by the state (could be entered, but did not pay) on a weekly basis with information from the previous week to Central Intake for upload into Quickbase
o Completes utilization report from Interactant by the 5th business day of the month and sends to Central Intake for upload into Quickbase showing:
 Overutilization of services
 Underutilization of services
 Requirement for immediate plan revisions
o Runs 2K report after care cost withdrawals (first business day after the 1 1 th) and sends to Central Intake for upload to Quickbase Uploads monthly reported Revenue into AR system
o Bills electronically or manually all authorized services provided
o Completes all 4116s for adaptive aids/dental/minor home modification billing and submits to state for payment authorization.
o Runs monthly report by procedure code Self Pay and CLIAB from Interactant to complete Cost Care transfers.Qualifications:

• Must have a High School diploma or GED equivalent
• Two years of related office management or bookkeeping experience. Human Resources experience preferred
• Must be proficient with Microsoft Word and Excel

About our Line of Business: ResCare Community Living has four decades of experience in the disability services field, providing support to individuals who need assistance with daily living due to an intellectual, developmental or cognitive disability. Our community living services are provided in 27 states with several thousand programs and a comprehensive range of high-quality services, including: Community Living, Adult Host Homes for adults regardless of disability, Behavioral/Mental Health Support, In-home Pharmacy Solutions, Telecare and Remote Support, Supported Employment and Training Programs, and Day programs. For more information, please visit www.rescarecommunityliving.com. Follow us on Facebook and LinkedIn. Salary Range: USD $22.00 / Hour