Financial Counselor

Overview

Job Summary

Reviews the information obtained from the patient interview to determine Medicaid eligibility. Apply for Medicaid on the patient's behalf, submit documents to the appropriate government agency, follow the Medicaid application through to the application determination and appeal Medicaid denials for possible decision reversals.

• Attends all Medicaid trainings to consistently to adhere to all government policy updates.

• Checks insurance verification systems to verify if a patient has any form of active coverage.

• Determines correct Medicaid program the patient is eligible to receive.

• Determines if the patient needs retroactive and/or ongoing coverage.

• Appropriately refer accounts to the Medicaid Disability Specialists to determine patients' potential for a 12-month disability.

• Applies for Medicaid through the local Department of Social Services.

• Submits the information requested by the Caseworker on the request for information.

• Obtains patient's employment and banking information with patient's signed AR form.

• Contacts the Department of Social Services to determine if a pending Medicaid application is on file and which caseworker has been assigned to the application.

• Contacts Disability Determination Services to determine which examiner has been assigned and if medical records have been requested.

• Notes all steps taken for all contacts made to patients, DSS and DDS.

• Appropriately refer accounts to attorney group for guidance on Medicaid best practices and next steps.
• Refers appropriate denied applications to the Medicaid Appeals Specialist to determine if a state appeal is appropriate.

Education, Training, and Experience

High School Diploma or GED required; Bachelors Degree in job related field preferred. Must have knowledge of financial coverage and regulations in long-term care. 5 years experience in long-term care social work, admissions and/or financial services. Must demonstrate positive, cooperative communication with a variety of customer and peers.

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