Job Description
Job Details
Level
Entry
Job Location
The Good Shepherd - Ashland, OH
Position Type
Full Time
Education Level
None
Travel Percentage
None
Job Shift
Day
Job Category
Insurance
Business Office Assistant/Medicaid Coordinator
GENERAL SUMMARY:
Responsible to oversee and manage all aspects of the Medicaid application and re-application processes. Assist resident/resident families, departmental staff and governmental agencies with education and resources in the application and processing of Medicaid Program coverage. Verification and maintenance of current Medicaid residents enrolled in the Medicaid Program. Other assigned duties to support the general Business Office (BO) operations and any duties assigned by Business Office Manager (BOM) and Administrator.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Provide information and assistance to resident (representative) and families needing to apply and receive Medicaid benefits.
Assist resident (representative) and families to gather necessary documentation to complete the Medicaid application and prepare for their face-to-face interview.
Document all transactions and monitor the progress of all applications.
Research to establish estimated Patient Liability (PL) amounts and communicate to all parties involved. Establish process for payment of estimated PL for pending applications.
Prepare Medicaid application, 9401, and Level of Care (LOC) requests and submit to the appropriate Agencies.
Work closely with BOM to assist in the collection of estimated and established monthly PL amounts.
Distribute copies of monthly Medicaid cards to the appropriate person and departments and distribute annual Representative Payee reports to Social Security.
Process and submit necessary paperwork required for Representative Payee requests. To include; Social Security, Pension, VA and any other recurring monthly income payments.
Process and submit necessary paperwork required for Change of Address forms. To include; Social Security, Pension, VA and any other recurring monthly income payments.
Scan review/results of PASSAR's, audit as requested by Social Service Department.
Assist in notifying resident (representative) and families if their Personal Needs Account is over $1500. Work with BO Associate, Social Services and Activities to help with management and spend down.
As directed by BOM, assist with month end statement processing as necessary and assist residents (representatives) and families to questions pertaining to monthly statements.
Responsible for communication with Hospice pertaining to monthly billing.
Other BO and BOM assigned duties may include: (not an all-inclusive list)
Filing BO paperwork, set up patient charts, copy and mail documentation requests
Post Private payments and maintain Private accounts
Business Office Assistant/Medicaid Coordinator
Continued, Page 2
Assist BOM with collection processes and notifications and certified mailing
Assist as directed by BOM with Ancillary charges to include; ambulance, lab, x-ray, therapy, oxygen, pharmacy and others
Learn duties of BO Assistant as directed by BOM
Perform other duties as assigned.
REPORTING RELATIONSHIPS
SUPERVISES: N/A
EDUCATION: High school education or equivalent.
EXPERIENCE: Previous Medicaid process experience in a long-term care or institutional setting preferred.
SKILLS & ABILITIES:
Knowledge of Microsoft Office package
Decision-making abilities
Problem-solving abilities
Ability to reason
Ability to communicate both verbally and in writing with a wide range of people.
Ability to work well with people and independently
Detail-oriented
Ability to maintain confidentiality
OTHER REQUIREMENTS:
Flexibility in managing schedule including weekends and evening hours.
Valid Ohio driver's license, access to reliable insured transportation and ability to meet LSS insurance standards required
Physical Requirements
Rarely
(0-12%)
Occasionally
(12-33%)
Frequently
(34-66%)
Regularly
(67-100%)
Seeing: read reports and use computer
X
Speaking & Hearing: communication with clients and co-workers
X
Standing/Walking
X
Climbing/Stooping/Kneeling
X
Lifting/Pushing/Pulling up to 25 lbs
X
Lifting/Pushing/Pulling 25-50 lbs
X
Lifting/Pushing/Pulling 50-100 lbs
X
Lifting/Pushing/Pulling over 100 lbs
X
Fingering/Grasping/Feeling: write, type, use phones, etc.
X
Sitting for extended periods of time
X
Working Conditions
Normal office working conditions with the absence of disagreeable elements.
Note: The statements herein are intended to describe the general nature and level of work being performed by employees and are not to be construed as an exhaustive list of responsibilities, duties and skills required of personnel so classified. Furthermore, they do not establish a contract for employment and are subject to change at the discretion of the employer.
LSSCO is an EOE. M/D/V/F
