What are the responsibilities and job description for the Medicaid Coordinator position at Queens Blvd Extended Care Facility INC?
Job Summary
The Medicaid Coordinator is responsible for assisting clients with Medicaid eligibility enrollment, recertification, and on-going case management in compliance with New York State and New York City Human Resources Administration (HRA) regulations. This roll serves as a liaison between clients, healthcare providers, managed care organizations, and government agencies to ensure uninterrupted Medicaid coverage and access to services.
Key Responsibilities:
- Assist clients with Medicaid applications, renewals, recertifications, and changes in coverage.
- Determine eligibility based on New York State and City guidelines, income, and residency requirements.
- Collect, review, and submit required documentation to NYC HRA and NY State of Health
- Monitor case statuses and follow up on pending applications or required documentation.
- Coordinate with healthcare providers, managed care plans, and social services agencies.
- Educate clients and families on Medicaid benefits, managed care options, and available services.
- Maintain accurate and timely documentation in electronic and paper case management systems.
- Resolve coverage issues, denials, or terminations through appeals or corrective action.
- Ensure compliance with HIPPA and confidentiality regulations.
- Stay current on changes to NYS Medicaid policies, HRA procedures, and managed care plans.
Qualifications
- High School diploma or equivalent required; associate or bachelor’s degree in social work, healthcare administration, or related field preferred
- 1-3 years of experience working with Medicaid, public benefits, or healthcare eligibility programs (NYC experience strongly preferred)
- Knowledge of NYS Medicaid, NYC HRA processes, and managed care plans
- Strong organizational and documentation skills
- Excellent verbal and written communication skills
- Ability to work with diverse populations in a challenging environment.
- Proficiency in Microsoft Office and electronic case management systems
- Bilingual (Spanish, Mandarin, Cantonese, Russian, or other NYC-relevant languages) a plus
Preferred Skills
- Experience with vulnerable populations (seniors, individuals with disabilities)
- Familiarity with long-term Medicaid, Medicaid Managed Long-Term Care (MLTC), or home care services.
- Strong problem-solving and advocacy skills
Work Environment
- Office, healthcare facility, or community- based setting
- May require interaction with government agencies and external partners.
Job Type: FULL-TIME
Benefits:
Medical Insurance
Dental & Vision
401K
PTO