Eligibility & Financial Redetermination Rep

About the Role

InnovAge offers an alternative to nursing homes through its Program of All-inclusive Care for the Elderly (PACE), providing enrolled seniors with customized healthcare and social support at PACE Adult Day Health Centers. As an Eligibility & Financial Redetermination Representative, you will assist participants and their families or caregivers in the annual Medicaid redetermination process.

Responsibilities

• Assist participants and their families/caregivers in the annual Medicaid redetermination process, including obtaining documentation, providing resources, and completing 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 in an easily understandable way to participants, families, and caregivers.
• 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 caregivers in completing necessary paperwork for Medicaid redetermination, collaborating with county government technicians to assess additional documentation.
• 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 easily accessible.
• 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.
• Valid state-issued driver’s license, personal transportation, good driving record, and auto insurance as required by law.

Preferred Qualifications

• Bilingual.

Benefits

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

Pay

$21.15 - $24.33 per hour.

This position requires a background screening through the Florida Care Provider Background Screening Clearinghouse for Florida applicants.