Eligibility & Financial Redetermination Rep

Job ID and requisition details available upon request.

About the role

InnovAge offers an alternative to nursing homes through its Program of All-inclusive Care for the Elderly (PACE), which provides enrolled seniors with customized healthcare and social support at PACE Adult Day Health Centers. These centers are staffed by medical professionals who are committed to creating personalized care plans for each participant.

Responsibilities

• Assist participants and their families/caretaker(s) in the annual Medicaid redetermination process, including obtaining documentation, providing resources, and assisting with necessary paperwork.
• Complete all re-determinations for InnovAge PACE participants assigned 30 days before the case due date.
• Monitor the Medicaid aging report and clear aged items in a timely manner.
• Communicate policies and procedures of Long Term Medicaid, Spousal Impoverishment, and Trusts to participants, families, and caregivers in an easily understandable way.
• Perform home visits and/or Day Center visits to complete Medicaid redeterminations within required time frames, prioritizing participant convenience and efficiency.
• Assist participants, families, and caretaker(s) in completing necessary paperwork for Medicaid redetermination, collaborating with county government technicians to assess additional documentation needed.
• Document work and outcomes in the Participant Tracking System Record of Contact Notes and the department tracking model.
• Organize caseload and working area efficiently to ensure information is accessible when unavailable.
• Complete disenrollment forms for HMOs and forward them to the supervisor in a timely manner.
• Process participant/Intake/social worker housing forms and complete new supporting housing forms for all RV’s if there is a differential in income.

Requirements

• Current knowledge of the Medicaid system/benefits and community resources available to seniors and their families.
• High School diploma or GED required.
• Valid state-issued driver’s license, personal transportation, good driving record, and auto insurance as required by law.

Preferred Qualifications

• Bilingual skills.

Benefits

• Medical, dental, and vision insurance.
• Short and long-term disability coverage.
• Life insurance and AD&D (Accidental Death & Dismemberment).
• Supplemental life insurance.
• Flexible spending accounts.
• 401(k) savings plan with company match.
• Paid time off and company-paid holidays.

Pay

Posted pay range: $19.76 - $22.74 per hour.

Additional Information

This position requires a background screening through the Florida Care Provider Background Screening Clearinghouse for Florida applicants. For more information, visit the Clearinghouse Education and Awareness website.