Job Summary:

The role of the Medicaid Specialist is to carry out all functions of New York State Medicaid applications, manage insurance information, and perform various other financial office tasks while maintaining accurate records of all financial transactions.

Key Responsibilities:

• Assist residents and designated representatives in completing NYS Medicaid applications.
• Work closely with Department of Social Services case workers to ensure Medicaid applications are processed timely and accurately.
• Responsible for all 3559 reporting to counties.
• Ensure payer source is maintained for all residents and communicate any issues to the Business Office Supervisor/Administrator.
• Refer and send over problem cases to our attorney.
• Contact attorneys or outside consultants to verify that they have been retained, obtain letters of representation if they are handling the Medicaid application, and follow up accordingly.
• Collaborate with the in-house biller to provide necessary billing information and updates on pending Medicaid applications, and attend weekly meetings with the Business Office Supervisor as necessary.
• Assist residents and designated representatives with billing questions in collaboration with the facility biller.
• Responsible for re-certifying Medicaid certifications.
• Assist with yearly reporting for accountants, surveys, etc.
• Maintain files in the back storage room and prepare for the annual shift of files.
• Adhere to all facility and department policies and procedures.
• Ensure all HIPAA requirements are followed.
• Perform other related duties as required and assigned.

Qualifications:

Education:

• Minimum High School Diploma (or equivalent).

Experience:

• At least 2 years of experience as a bookkeeper.
• Experience in completing NYS Medicaid applications.

Professional Skills and Abilities:

• Excellent communication and organizational skills.
• Ability to work well under pressure and be flexible.
• Exemplary customer service skills.
• Competent computer skills with knowledge and understanding of Microsoft Word and Excel.
• Capacity to thrive under pressure and adapt to changing demands.
• Superlative customer service acumen.
• Proficient in using billing software and Microsoft Office applications (Excel, Word, Outlook).
• Excellent interpersonal skills.
• Ability to prioritize responsibilities, meet deadlines, and manage time effectively.

Physical Requirements:

• Physical ability to perform job-related duties, which may include sitting for extended periods, moving files, and occasionally lifting up to 25 lbs.