St. Johnland Nursing Facility is a 250 bed premier provider for skilled nursing care.

Medicaid Coordinator – SJNC/ALP

Main Responsibilities (SNF):

• Handle yearly recertifications for active chronic care Medicaid residents in our SNF. Work with families to get release signed, obtain documentation, and complete the recertification. Follow up with any PEND letters.
• Prepare facility paperwork to accompany new chronic care Medicaid applications for our SNF residents (coordinate with attorneys, consultants, and/or family members). Then follow up with families, attorneys and/or consultants regarding the status of those new Medicaid applications. Follow up with any PEND letters, that they are being address by the attorney, consultant, and/or family.
• Prepare and mail Private Pay/Pending Medicaid invoices for Pending Medicaid residents.
• Correspond with local DSS offices for our active chronic care Medicaid residents to report any census changes, income changes, health insurance premium changes, request budget updates, or confirm current budgets. Submit any forms, requests, or documentation as needed.
• Track and advise case management/social work regarding active Medicaid residents who are on Managed Long Term Care Plans (MLTCs). Follow up to ensure current authorization is on file, and that our facility is in-network with the MLTC plan. Advise families & case management if coverage is appropriate or if disenrollment is needed.
• Assist with and respond to resident’s mail that requires verification of insurance (doctors office and other medical bills requiring insurance information)
• Scan and file any notices, budgets, and notices of decision from any DSS office
• Advise case management , families, and residents if a Medicaid recipient has appropriate coverage.
• Prepare and send any non-compliant cases to our collections attorneys.

Main Reponsibilities (ALP):

• Notify local DSS offices of new admissions with a letter of residency, LDSS-3559 or other appropriate form and follow up to ensure proper billing codes are entered by DSS into the PPS screen for our ALP to bill.
• Correspond with local DSS offices for our active ALP Medicaid residents to report any census changes. Confirm any monthly overages based on Medicaid budgets received. Submit any forms, requests, or documentation as needed.
• Inform families of any overage changes or notices of recertifications, to ensure they are being handled.
• Follow up with attorneys and/or families regarding the status of Pending Medicaid applications
• Scan and file any notices, budgets, and notices of decision from any DSS office
• Prepare and send any non-compliant cases to our collections attorneys.

Other general responsibilities: (SNF & ALP)

Filing, scanning, maintaining resident’s files (both ALP and SNF)

Cover for Personal Needs Accounts / Petty Cash when necessary

Interact with DSS, residents and families, attorneys, consultants, and other facility personnel.

Assist with any special projects or audits as requested

Daily banking

Skills/experience:

• 1 year of experience as a Medicaid Coordinator or similar role
• Strong knowledge of Medicaid regulations and processes
• Excellent organizational and time management skills
• Effective communication skills, both written and verbal
• Ability to work independently and collaboratively within a team environment
• A commitment to upholding patient privacy and confidentiality

We are an Equal Opportunity Employer offering a generous benefit package.

Salary commensurate with experience.

Job Type: Full-time

Pay: $49,000.00 - $52,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee discount
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift

Work setting:

• In-person
• Skilled nursing facility

Work Location: In person