Long Term Care Specialist

Job Summary

The Long-Term Care Specialist is a member of the Operations Team responsible for interacting with referrals from facilities and assisting patients in applying for Long-Term Care or other Medical Assistance programs through State, Federal, County, Medical, or Disability agencies.

Essential Duties And Responsibilities

• Detailed in-house review and bedside interviews to determine patient eligibility for Long-Term Care or other Medical Assistance programs.
• Aid in the application process for applicable programs, including investigative, medical review, and administrative work.
• Mentor and guide Eligibility staff in proper procedures and skill development.
• Evaluate and assess employee progress under supervision.
• Interact with senior management and clients professionally, courteously, and with advanced customer service skills.
• Assist patients, patient representatives, and families in determining eligibility for Long-Term Care or other Medicaid programs.
• Explain eligibility requirements, application processes, and verification requirements to patients and other entities.
• Aid in the facilitation of the application process by assisting patients in completing applications, scheduling appointments, and obtaining required verifications.
• Document pertinent patient information and account activity in appropriate systems.
• Request and track field visits, utilizing correct criteria as per Elevate training manuals.
• Monitor patient accounts to ensure appropriate processing timeframes are met.
• Maintain confidentiality regarding patient health records and Elevate business practices.
• Conduct business ethically, promoting Elevate's Mission, Vision, and Values.
• Work with upline leadership on other duties as assigned to ensure Elevate's outcomes as a single organizational entity.

Qualifications And Requirements

• Some college and two years related experience or some combination of education, related experience, and/or training.
• Advanced understanding of the Medical Assistance application process, including eligibility analysis and evaluation.
• Knowledge of multiple state/federal/local program policies and procedures.
• Effective use of a PC, including various database programs.
• Accurate typing/data entry at a minimum of 30 wpm.
• Proficiency in Microsoft Office applications, including advanced Excel, charts, graphs, and PowerPoint.
• Effective communication skills, both written and verbal.
• Ability to read and understand Standard English text, such as administrative policy and procedures manuals.
• Ability to establish and maintain cooperative working relationships with patients, third-party resources, co-workers, and management.
• Ability to follow complex instructions and procedures, paying close attention to details and organizing work efficiently.
• Skilled in organizing and setting priorities, accurately reflecting the relative importance of job responsibilities.
• Skilled in speaking clearly and distinctly using appropriate vocabulary and grammar to obtain necessary information.
• Availability of reliable transportation for use in Field Visits.
• Remote and Hybrid positions require home internet connections meeting the Company’s upload and download speed criteria.