Job Information
PruittHealth CCSP Medicaid Specialist - Home First in NORCROSS, Georgia
JOB PURPOSE:
Assists the Elderly and Disabled Waiver Program (EDWP) clients who do not have active Medicaid eligibility [Potential Medicaid Assistance Only (PMAO) or Medicaid Assistance Only (MAO)], with the Medicaid Application process and follows up with the Division of Family and Children Services (DFCS) to ensure the clients’ eligibility process is complete.
KEY RESPONSIBILITIES:
Assists with EDWP Intake. Monitors PMAO and MAO referrals and census data.
Coordinates with Home First Case Management agencies in determining EDWP clients’ MAO or PMAO eligibility or continued eligibility status
Assists EDWP clients with the Medicaid Application process and renewals
Collects copies of financial documents from EDWP clients and submits to DFCS
Completes and uploads necessary provider forms to Georgia Gateway
Follow-up with DFCS routinely using the Medicaid Provider Status Request spreadsheet
Document follow-up with EDWP clients and DFCS via the DCH/DDS electronic data system
Verify Medicaid eligibility or continued eligibility via the Georgia Medicaid Management Information Systems (MMIS)
Maintains Medicaid documentation in accordance with EDWP operating procedures and policies as well as auditing entities for Medicaid.
KNOWLEDGE, SKILLS, ABILITIES:
• Knowledge of Georgia Medicaid
• Proficient in using Microsoft Office (Outlook, Word, Excel)
• Excellent verbal communication skills, and basic typing ability
MINIMUM EDUCATION REQUIRED:
Bachelor's degree in a related field from an accredited college or university OR Associate's degree from an accredited college or university AND One year of related experience OR High school diploma or GED AND Three years of related experience
MINIMUM EXPERIENCE REQUIRED:
One (1) year experience in Medicaid billing, collections, or recovery OR One (1) year experience in the Division of Family and Children Services (DFCS) MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW: N/A
ADDITIONAL QUALIFICATIONS: (Preferred qualifications)
• B.S. degree in Social Work or in a related field
• Prior experience in the Division of Family and Children Services (DFCS) in the Aged, Blind, and Disabled (ABD) unit
• Two (2) years’ experience in Medicaid billing, collections, or recovery
• Demonstrated knowledge of electronic data systems
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As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status.