Medicaid Managed Care Liaison

Background

Forestdale (FD) is a NYC child welfare agency working to prevent child abuse/neglect through parenting, prevention, and foster care (FC) services, focusing on low-income and immigrant communities in Queens and Brooklyn. We help thousands of families work through acute and complex trauma, parents raise the next amazing generation of children, and youth successfully launch into adulthood. FD’s mission is “to ensure that children and families have the fundamental assets they need to thrive and live independently.

Job Summary

The Medicaid Managed Care Liaison (MMCL) organizes the exchange of health information, treatment planning, discharge planning, and documentation for cases assigned to him/her.  This includes arranging for medical escorts, transportation and supervision to health care appointments in the community.  This position maintains all clerical and clinical documentation in compliance with NY State and City regulations. 

Major Responsibilities/Activities for this position include:

• Coordinating with the Managed Care Organizations (MCOs):
  1. MCO enrollment, disenrollment, transitions
  2. Completing transmittal forms and troubleshooting insurance issues
  3. Managing insurance cards for all clients. 
  4. Assisting with Primary Care Provider changes
  5. Seeking MCO approval for services ordered by court 
  6. MCO credentialing and recredentialing for the clinic and providers as needed.
  7. Facilitation of a single case agreement when a child is placed outside of the MCO service area or provider network
• Billing support for Article 29i and CFTSS services
  1. Ensure claims are submitted correctly
  2. Address billing errors as they may arise. 
  3. Invoicing and reconciliation as needed. 
• Administrative support of clinic functions
  1. Document pertinent information in the EHR
  2. Communicate with clients/ patients in regards to all insurance related issues. 
  3. Additional duties as assigned. 

Minimum Requirements 

• Associate’s degree or higher required.  
• Knowledge of Medicaid billing processes
• Proficient in Microsoft Office 
• Minimum of two years of work experience in billing and dealing with medical/ mental health claims.
• Strong organizational, verbal and written communication skills
• Ability to multitask
• Compliance with:
• Required background checks, including: NYS Statewide Central Register of Child Abuse/Maltreatment, NYS Sex Offender Registry, NYS Division of Criminal Justice Services fingerprinting, NYS Justice Center Staff Exclusion List, NYS OMIG Medicaid Exclusion List.
• Mandated reporter training.
• Applicable provisions of the NYS Education Law with respect to hiring and retaining of licensed professionals.

Salary: $25.50 (~$46,500)  - $27.47 (~$50,000)

Benefits:  Join the Forestdale Team and Enjoy Excellent Benefits:

• Four weeks’ vacation
• Medical/dental/vision/life/disability insurance
• 401(k), 7% employer contribution 2% match
• Tax-deferred health care/dependent care/commuter plans
• Flexible Schedule
• Opportunities for educational scholarships

Additional Information

Forestdale Inc. is an equal opportunity employer that is proudly committed to becoming an anti-racist and multicultural organization that stands up for justice and equity. We welcome prospective employees from diverse backgrounds, for administrative support and direct service and leadership roles, who will join us on that journey, uphold our values and approach, and believe in our mission. Additionally, we aim to have a racially representative leadership and workforce that is reflective of the communities we work in partnership with.
   
Forestdale Inc. is committed to providing an inclusive and welcoming environment for all members of our staff, participants, volunteers, subcontractors, and vendors. We do not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of our activities or operations. These activities include, but are not limited to, hiring and termination of staff, selection of volunteers and vendors, and provision of services.