Enrollment Specialist

Job Description

Job Description

McGregor PACE (Program of All-Inclusive Care for the Elderly), is a community service program that provides in-home healthcare services to the elderly as an alternative to nursing home placement, allowing seniors to remain at home.

We are looking for an Enrollment Specialist who will be responsible for submitting the Medicaid application and required verifications for PACE applicants to establish Medicaid eligibility and act as the applicant’s Medicaid Authorized Representative.

Responsibilities :

• Determines Medicaid eligibility for PACE applicants.
• Acts as Medicaid Authorized Representative for McGregor PACE applicant
• Arranges initial and ongoing home visits with applicants and / or families related to obtaining necessary authorizations and verifications for Medicaid eligibility determination.
• Completes the Medicaid application and submits required verifications to the Special Medicaid Benefits Center (SMBC) for Medicaid eligibility determination.
• Follow up on all aspects of the applicant’s Medicaid application process with SMBC and other organizations to obtain needed verifications to determine eligibility for Medicaid benefits.
• Consistent communication with the Director of Enrollment and staff regarding progress or delays that affect applicants program eligibility.
• Documents all activities during the Medicaid application and enrollment process.
• Participates in meetings as appropriate including the weekly Intake Meeting and weekly Team Meeting. Other meetings as assigned.
• Updates documents to the applicant’s electronic files and ensures related spreadsheets are up to date promptly.
• Develop correspondence for appropriate communication to staff and applicants.
• Serves as a resource to participants, families, and McGregor PACE staff for Medicaid eligibility.
• Completes routine reports and paperwork.
• Completes the temporary insurance card and welcome packet for newly enrolled / confirmed PACE participants and informs applicant / family of status.
• Upload the temporary insurance card and welcome packet to Electronic Medical Record.
• Once the applicant is confirmed by ODA, ensure their electronic file is complete and ready to be transferred to the Eligibility Department.
• Other duties as assigned.

Minimum Qualifications :

Preferred Qualifications :

We offer competitive compensation and EXCELLENT BENEFITS which include :