Insurance Specialist

Job Description

Job Description

Insurance Specialist

We are so excited to announce that BoldAge PACE has a opened 2 new locations in Evansville, IN and Owensboro, KY!

About Us

BoldAge delivers innovative, creative solutions for PACE (Program of All-Inclusive Care for the Elderly). Our model of care enables older adults to live a meaningful, independent life at home with grace and dignity.

We meet the evolving needs of older adults by providing innovative disciplinary solutions that consider both their physical and mental well-being.

Our owner operated model is aimed at expanding the ability for older adults to live happily and healthfully in their own homes for as long as possible.

JOB SUMMARY

Under the supervision of Business Operations Manager is responsible for assisting participants and families in the application process for Medicaid.

Maintains log of Medicaid eligibility. Meets with family and / or potential participant to complete Medicaid application, to ensure eligibility for enrollment.

Assists Medicaid Representatives in difficult situations that may arise, which may include meeting with participants, families, social workers and county workers.

Assists with any open position case loads. Training of new employees on home visits, Medicaid rules and regulations, examples of potential difficult situations, and Supportive Housing Forms.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Works closely with Marketing and Enrollment Specialists and the Accounting Department to ensure Medicaid payment for eligible participants.
• Provides support and back-up to the Enrollment Specialist with regards to Medicaid operations. Works with Medicaid staff to resolve difficult cases.
• Works with the Enrollment / Marketing Staff on getting Medicaid approval for new enrollees. Effectively communicates with the Enrollment / Marketing staff on the status of cases and problem solves challenges on gathering information.
• Provide excellent customer service skills and works with families and participants in a timely manner to assist them in completing the paperwork needed for Medicaid eligibility.
• Develops and maintains working relationships with county technicians and provides any additional information needed when requested to ensure timely approval of cases.
• Will maintain a good working knowledge of current Medicaid rules and regulations and be able to communicate these regulations confidently to family members and participants.

Straight Medicaid, LTC Medicaid, Spousal Impoverishment and Trusts.)

• Will have efficient and organized case load and working area.
• Responsible for completing disenrollment forms for HMO’s to be disenrolled and given to supervisor.
• Performs as a representative by participating in community committees’ when appropriate.
• Follows all Policies and Procedures and OSHA safety guidelines.
• Maintains the confidentiality of all company procedures, results, and information about participants, clients or families.
• Handles potentially infectious specimens with appropriate biohazard precautions, and practices Universal Precautions.
• Maintains courteous, helpful and professional behavior on the job. Displays a willingness and ability to be responsive in a warm and caring manner to all customer groups.

Consistently cooperates and supports organization in problem solving issues. Ensures customer satisfaction by understanding and applying the Customer Service Policy, Procedure and Standards.

Will support the success of the entire healthcare team.

• Maintains safe working environment. Follows Safety Policies and Procedures.
• Participates in continuing education classes and any required staff and training meetings. Maintains professional affiliations and any required certifications.
• Performs other duties as required or requested in a positive and helpful manner to ensure a smooth-running work area.

REQUIREMENTS

• Knowledge of Medicaid system and benefits
• High school diploma required
• Must have reliable transportation, a valid driver's license, and the minimum state required liability auto insurance.
• Be medically cleared for communicable diseases and have all immunizations up-to-date before engaging in direct participant contact.
• Pass a comprehensive criminal background check that may include, but is not limited to, federal and state Medicare / Medicaid exclusion lists, criminal history, education verification, license verification, reference check, and drug screen.

BoldAge PACE provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

Monday - Friday

8am - 5pm

40 hours