- Where
- Box Elder, MT, United States
- Level
- Mid
Position Summary:
This position is responsible for the professional administration of ACA Medicaid Programs for single adults, families, children, and pregnant women. Eligibility determination and case management of multiple programs are accomplished through a series of analysis and evaluations by interpreting and applying the appropriate Federal and State mandated rules and other Medicaid programs
Key Responsibilities: Analyze, determine eligibility, and authorize benefits; analyses information to identify potential client eligibility for appropriate programs, evaluates household composition, resources, income and expenses and their effect on eligibility for each client and program, Using knowledge of federal and state laws, rules and regulations, and laws regarding real estate, finances, estates etc., applies different policies or budgeting methodologies to meet client's individual needs and to determine eligibility for programs.
Request, review, and evaluate supporting documentation necessary to complete eligibility determinations.
Process Medicaid renewals, redeterminations, and reported changes that may affect continued eligibility.
Maintain accurate and complete case records, documenting eligibility decisions, verification information, and other actions taken.
Communicate with applicants regarding application status, eligibility decisions, required documentation, and additional information needed.
Coordinate with Patient Registration, Alternate Resources, and other departments to address Medicaid coverage and eligibility concerns.
Daily coordination with the tribal Business Process Specialist.
View RBHC appointment list pre-appointment and daily to verify patients’ health insurance and use as a to enroll patients in health insurance.
Document all encounters and work activities and provide monthly reports to supervisor.
Other duties as assigned.
Minimum Qualifications: High school diploma or equivalent
Preferred Qualifications: Associates or Bachelor’s degree in related field