Medicaid Resource Specialist

About Us:

ALM Hopewell Center provides comprehensive mental health services to children and adults in the northern and central parts of the City of St. Louis and North St. Louis City. A professional mental health staff serves a growing caseload of 2,800 patients, of which greater than ninety-five percent are chronically mentally ill and suffering from major psychiatric disorders. Hopewell Center operates a Psychosocial Rehabilitation Center and a Comprehensive Psychiatric Rehabilitation Center for adults and youth. Many services are provided at schools. Emergency services, including a crisis bed and mobile outreach, are available twenty-four hours per day. A multi-disciplinary team of psychiatrists, psychologists, nurses, counselors, social workers, educators, and support staff work diligently to carry out the mission of providing comprehensive care to patients and their families.

PRIMARY DUTIES AND RESPONSIBILITIES:

Assist client with Medicaid application process. Development and distribution of reports to monitor progress and/or problems. Oversight of the registration process (as it pertains to fund sources and data entry), assurance of accurate completion of all required paperwork. Ensures that the errors on the billing reports get corrected. Coordinates Medicaid applications with DFS workers; Tracks dates of applications and follows up. Reviews reports for Medicaid application re-application. Provides notification to CSS and managers that this is coming due to ensure people do not lapse. Troubleshoots Medicaid rejections and spend-down rejections and ensures action is taken to help address the problems. Monitors client eligibility reports to proactively assist clients in re-applying for Medicaid. Reviews reports and follows up with clients in the Rehab programs who have high levels of POS billing. Provide follow-up for on-site Medicaid spend downs by giving a printout of all cost incurred through Hopewell Center and Omni-Care Pharmacy to DFS worker. Assist clients with obtaining any billing information from outside DFS agencies to support spend-down process. Provides education to staff when there are multiple errors. Assure staff members are educated on the various parts regarding Medicaid, spend-down, etc.

Education and Experience:

• Bachelor's Degree or combination of Associates Degree and 2 years of experience.
• Desired experience in Medicaid Eligibility and government programs; certifications in training; Comprehension of regulations
• Proficient in Microsoft Excel (Pivot Tables/Formulas)
• Ability to learn other applications necessary for database management
• Ability to work independently and efficiently

People's Family of Corporations does not discriminate on the basis of race, creed, color, ethnicity, national origin, religion, sex, sexual orientation, gender expression, age, height, weight, physical or mental ability, veteran status, military obligations, and marital status

Last updated on Oct 22, 2024