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Senior Medicaid Recertification Assistant
Contacts and assists VNS Health Plans members with Medicaid applications and recertification. Enters and updates member demographic information into the Recertification Tracking Tool. Identifies and investigates problematic recertification cases and presents for resolution. Works under general supervision.
Compensation:
$20.98 - $26.23 Hourly
What We Provide
- Referral bonus opportunities
- Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays
- Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
- Employer-matched retirement saving funds
- Personal and financial wellness programs
- Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
- Generous tuition reimbursement for qualifying degrees
- Opportunities for professional growth and career advancement
- Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities
- Interdisciplinary network of colleagues through the VNS Health Social Services Community of Professionals.
What You Will Do
- Reviews patient referrals and determines eligibility for Medicaid. Processes Medicaid applications. Conducts follow up contact with members when additional information is needed. Ensures proper documentation is recorded in the Recertification Tracking Tool.
- Submits Medicaid applications to Human Resources Administration (HRA) office.
- Assists members with any inquiries in regards to surplus payments and fee assessments when member claims hardship.
- Submits Stensen, Milestone, and PA applications to HRA for SSI members who have lost coverage.
- Prepares problem/escalated cases for management to review and resolve.
- Prepares weekly and monthly productivity reports for Management to review.
- Analyzes and investigates recurring issues; takes appropriate action including escalation to Senior Medicaid Recertification Coordinator or Supervisor. .
- Sends out Medicaid Recert packets to members in preparation for their Medicaid recertification.
- Develops and sends lists of members that need to be disenrolled to the Member Eligibility Unit (MEU) (non recertified, expired, non-compliant, or ineligible members).
- Scans, files into document repository; retrieves files as requested.
- Monitors members in the recertification process to ensure resolution.
- Participates in special projects and performs other duties as assigned.
Qualifications
Education:
Associate's Degree in health, human services, other related discipline or equivalent work experience required
Work Experience:
Minimum two years experience in health care, insurance, or social services processing bills and Medicaid applications required
Effective oral, written, verbal communication and customer service skills required
Personal Computer skills including Microsoft Word and Excel required
Analytical skills, including compilation and analysis of data, report creation and recommendations based on findings preferred
About Us
VNS Health is one of the nation’s largest nonprofit home and community-based health care organizations. Innovating in health care for more than 125 years, our commitment to health and well-being is what drives us—we help people live, age and heal where they feel most comfortable, in their own homes, connected to their family and community. On any given day, more than 10,000 VNS Health team members deliver compassionate care, unparalleled expertise and 24/7 solutions and resources to the more than 43,000 “neighbors” who look to us for care. Powered and informed by data analytics that are unmatched in the home and community-health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of the communities and people we serve in New York and beyond.
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Mission & Values
As a team member of VNS Health, you share a passion for improving the health of patients through best-in-class care in the home and the community.
Inclusive Culture
At VNS Health, our priority is to create an environment where every team member feels they belong and are included.
Total Rewards
We provide our team members a well-rounded employment experience, competitive compensation, and a robust and affordable benefits package that serves you and your family. Our Total Rewards Program at VNS Health is an investment in your health, wealth and life.
