Medicaid Coordinator
American Medical Associates, New York, NY, United States
Medicaid Coordinator-Nursing Home
Salary : $55K to $70K
DUTIES:
Process Medicaid applications, conversions, and recertifications in accordance with NYS regulations
Meet with residents and/or their representatives to collect and analyze all required financial documentation
Review financial records to ensure compliance with Medicaid eligibility requirements, including income and asset guidelines
Manage Net Available Monthly Income (NAMI), including redirection of income and ensuring timely monthly payments
Monitor resident financial status and proactively communicate any barriers to payment to the facility and business office
Resolve issues related to denials, pending applications, and documentation discrepancies
Prepare for and participate in meetings with supervisors and facility staff to review aging reports and resident financial profiles
Work closely with the business office to ensure all avenues for securing payment are addressed
Maintain strong working knowledge of current New York State Medicaid regulations, including Chronic Care requirements
Utilize systems and tools (Excel, Outlook, Word, and facility software) to track cases and generate reports for management
Communicate with external agencies, LDSS/HRA, and law firms; initiate attorney referrals when necessary
Build relationships with financial institutions to obtain required documentation efficiently
Support non-clinical case management processes, including working with NOMNCs (Notice of Medicare Non-Coverage) as needed
Stay current with federal and state Medicaid policy updates and regulatory changes
REQUIREMENTS:
• Must have nursing home experience
• Minimum 2- 3 years of experience in Medicaid eligibility, long-term care billing, or healthcare finance
• Strong knowledge of New York Medicaid Chronic Care eligibility rules required
• Experience working with LDSS/HRA systems and processes highly preferred
• Prior experience in a nursing home or long-term care setting strongly preferred
#7539
Salary : $55K to $70K
DUTIES:
Process Medicaid applications, conversions, and recertifications in accordance with NYS regulations
Meet with residents and/or their representatives to collect and analyze all required financial documentation
Review financial records to ensure compliance with Medicaid eligibility requirements, including income and asset guidelines
Manage Net Available Monthly Income (NAMI), including redirection of income and ensuring timely monthly payments
Monitor resident financial status and proactively communicate any barriers to payment to the facility and business office
Resolve issues related to denials, pending applications, and documentation discrepancies
Prepare for and participate in meetings with supervisors and facility staff to review aging reports and resident financial profiles
Work closely with the business office to ensure all avenues for securing payment are addressed
Maintain strong working knowledge of current New York State Medicaid regulations, including Chronic Care requirements
Utilize systems and tools (Excel, Outlook, Word, and facility software) to track cases and generate reports for management
Communicate with external agencies, LDSS/HRA, and law firms; initiate attorney referrals when necessary
Build relationships with financial institutions to obtain required documentation efficiently
Support non-clinical case management processes, including working with NOMNCs (Notice of Medicare Non-Coverage) as needed
Stay current with federal and state Medicaid policy updates and regulatory changes
REQUIREMENTS:
• Must have nursing home experience
• Minimum 2- 3 years of experience in Medicaid eligibility, long-term care billing, or healthcare finance
• Strong knowledge of New York Medicaid Chronic Care eligibility rules required
• Experience working with LDSS/HRA systems and processes highly preferred
• Prior experience in a nursing home or long-term care setting strongly preferred
#7539