Medicaid Specialist
Care Initiatives Corporate Office
Waterloo, Iowa
medicaid
medicaid
nursing
medical
team
financial
data
managed care
assistance
representative
billing
healthcare
voluntary
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October 7, 2022
Care Initiatives Corporate Office
Waterloo, Iowa
OTHER
Are you looking to be a part of a fun team that positively impacts your community? At Care Initiatives we’re committed to celebrating life and helping those in our care live to the fullest. We love helping people gain their highest level of independence and quality of life during their time with us.
Care Initiatives is the largest single operator of quality nursing homes in Iowa. As a non-profit organization, we have proudly been investing millions of dollars into the communities we serve since 1989. Care Initiatives serves roughly 2800 Iowans through skilled nursing facilities, assisted living, and hospice locations. We are dedicated to providing compassionate care for Iowans through all of life’s transitions. “Always Learn” is one of our Core Values. We want you to learn and grow with us. Apply today to start your exciting new career with us!
Care Initiatives is now hiring a Medicaid Specialist to join our team!!
PURPOSE OF THE POSITION:
This work involves considerable independent responsibility. The Medicaid Specialist will work with residents and/or responsible representatives in the Cedar Rapids/Waterloo area to gather financial data and assist them through the Iowa Medicaid application process. They will inform the Medicaid applicant about the transition from Iowa Medicaid fee-for-service to Managed Care. Along with monitoring and directing the ongoing process of eligibility, reimbursement support, data analysis and strategic quality improvement planning is foreseen. The Specialist will continue their role by assessing private pay balances on an on-going basis and work cooperatively with field and corporate staff. Travel is required.
KEY RESPONSIBILITIES:
QUALIFICIATIONS:
BENEFITS:
Care Initiatives has implemented its Employee and Provider SARS-CoV-2 (“COVID-19”) Vaccine Policy pursuant to recent federal regulation, which requires all employees to have either their first dose of a COVID-19 vaccine or submit a medical or religious exemption request by February 14, 2022. If you have received at least one dose of a COVID-19 vaccine, please be prepared to provide proof of vaccination upon hire. If you would like to submit a medical or religious exemption request, the appropriate forms will be provided to you upon hire.
EOE, AAP, Veterans and Disabled Employer:
Care Initiatives is the largest single operator of quality nursing homes in Iowa. As a non-profit organization, we have proudly been investing millions of dollars into the communities we serve since 1989. Care Initiatives serves roughly 2800 Iowans through skilled nursing facilities, assisted living, and hospice locations. We are dedicated to providing compassionate care for Iowans through all of life’s transitions. “Always Learn” is one of our Core Values. We want you to learn and grow with us. Apply today to start your exciting new career with us!
Care Initiatives is now hiring a Medicaid Specialist to join our team!!
PURPOSE OF THE POSITION:
This work involves considerable independent responsibility. The Medicaid Specialist will work with residents and/or responsible representatives in the Cedar Rapids/Waterloo area to gather financial data and assist them through the Iowa Medicaid application process. They will inform the Medicaid applicant about the transition from Iowa Medicaid fee-for-service to Managed Care. Along with monitoring and directing the ongoing process of eligibility, reimbursement support, data analysis and strategic quality improvement planning is foreseen. The Specialist will continue their role by assessing private pay balances on an on-going basis and work cooperatively with field and corporate staff. Travel is required.
KEY RESPONSIBILITIES:
- Review all current and incoming residents who may need to apply for Medicaid financial assistance or begin planning as their private funds deplete.
- Assist the resident/responsible representative with the Medicaid application process and any additional requests made by the department; request for grace periods as needed in order to maintain the on-going Medicaid application status. Monitor the department’s progress and request updates as needed throughout the application process.
- Educate patients and families about the Managed Care Organizations (MCOs) in Iowa and inform them that they will need to make an MCO selection after being approved for Medicaid fee-for-service.
- Inform resident and/or responsible representative about Medicaid annual reviews that are coming due and assist them through the process to protect any lost reimbursement due to failure to comply with DHS annual review requests.
- Responsible for submitting prior authorization request to the MCO on all new Medicaid residents and/or inform all designated staff member(s). Notify the nursing department that a level of care assessment will need to be completed signed by physician; it may then be submitted online by the Medicaid Specialist.
- Review and update billing software to ensure completeness and accuracy of payer information.
- Actively participate in account research and billing process to better assist residents/families with understanding their billed charges and the consequences of delinquent accounts.
- Maintain relationships with each facility contact person for ongoing coordination of care. Educate contacts within each facility on updates and changes, as needed.
- Establish and maintain relationship with each MCO provider contact to ensure quality of care and management of system is completed timely, efficiently and to the resident’s benefit.
- Keep abreast of any current Iowa Medicaid Enterprise (IME) and MCO regulations and provider manual changes.
- Performs other duties and projects as assigned.
QUALIFICIATIONS:
- Associates or bachelor’s degree in accounting, finance, business or healthcare related field.
- Minimum 1-2 years healthcare experience is preferred
- At least 1-2 years social work experience is preferred
- Experience in educating families on Medicaid is preferred
BENEFITS:
- Dayforce Wallet- on Demand Pay- access your pay as soon as it is earned!
- Four different great medical plan choices!
- HSA and FSA Programs
- Two different dental coverage plan options
- Vision
- Retirement 403(b) Savings plan!
- Basic Life and ADD, Voluntary Life ADD, Short-Term and Long-Term Disability
- Voluntary Critical illness and Accident Coverage Plans
- Doctor on Demand, discounts on gym memberships, fitness equipment, ID Theft Protections, Be Well 24/7
- Discount Programs on Verizon Wireless, hotel, electronics, appliances, apparel and more!
- LPN RN Tuition Assistance Program
- LPN RN Board Funding
- Continuing Education (CE)
- Online Training
- Advancement Transfer Opportunities
- CNA Training Reimbursement
- Employee Referral Bonus
- Veteran’s Day Pay for Veterans
- Years of Service Recognition Program
Care Initiatives has implemented its Employee and Provider SARS-CoV-2 (“COVID-19”) Vaccine Policy pursuant to recent federal regulation, which requires all employees to have either their first dose of a COVID-19 vaccine or submit a medical or religious exemption request by February 14, 2022. If you have received at least one dose of a COVID-19 vaccine, please be prepared to provide proof of vaccination upon hire. If you would like to submit a medical or religious exemption request, the appropriate forms will be provided to you upon hire.
EOE, AAP, Veterans and Disabled Employer:
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