Manager, Medicaid Eligibility

Duties And Responsibilities

• Confirm patients’ eligibility for Medicaid by reviewing account notes in the department’s proprietary database
• Review completed applications to expedite the submission process
• Draft submission letters, emails and texts
• Post approval, review submission to make sure that all protocols were properly followed
• Track deadlines using Excel
• Create and review various reports on a continual basis
• Access hospital databases to obtain information needed for claims and reporting
• Communicate with the Department of Social Services to address any concerns or questions in relation to any submissions
• Review cases in the database to ensure statuses are up to date and accurate
• Deliver continual feedback to management for on-going processes and workflow improvement
• Request changes to workflow based on business needs with IT
• Aid in the development of protocols
• Prepare cases to be closed and notify the appropriate team members of their closing
• Coordinate team meetings and arrange any team events

Qualifications

• Associates degree or higher required
• Must have held a managerial position, preferably within the customer service field for at least 3 years with the ability to supervise others
• Experience with ePACES and LexisNexis is a plus
• Bilingual English/Spanish preferred
• Be able to effectively communicate with third parties
• Proficient in Microsoft Office applications (Excel, Word and Outlook)
• Good planning and implementation skills
• Strong investigatory, researching and problem-solving skills
• Excellent written and verbal skills
• Must have administrative experience
• Able to efficiently multitask
• Possess a high level of organization skills and be detail-oriented