Northwell Health Specialist, Medicaid in Melville, New York

Req Number 001SD7

Job Category Billing Clerical

Job Description

Assists patients who may be eligible for Medicaid coverage to complete the application process.

Responsibilities Include:

  • Informs the patient to execute an authorization, which empowers RCR to act on behalf of the patient in applying for Medicaid coverage.

  • Reviews the patient’s application and, based on his/her extension knowledge of local Medicaid requirements, determines any deficiencies that might exist.

  • Works closely with the patient, often making home visits. Helps the patient create a complete application with the appropriate back-up documentation.

  • Schedules meeting at social services to have patient’s file reviewed and processed. If there is a denial, attends a “Fair Hearing” as the patient’s representative and seeks to overturn prior denial.

  • Sets up a network of contacts at the Department of Social Services.

  • Coordinates efforts with the central office of RCR so the computer system is updated to the current status of the application.

  • Completes goals of completed applications every month.

  • Visits the main RCR office when necessary.

  • Works closely with personnel at the provider facility in addition to family members of the patient in order to gather all the documentation necessary to complete an application.

  • Stays apprised of any amendments or modifications to local Medicaid rules in order to submit proper applications.

  • Performs related duties, as required.

Qualifications

  • High School Diploma or equivalent, required.

  • NYS Driver’s License and availability of vehicle, required.

  • Aptitude to learn detailed regulations and filing requirements.