Performs complex work screening and reviewing applicants for possible TANF, Medicaid, Supplemental Security and Social Security eligibility potential. Work involves interviewing clients, verifying financial information and other case data. Will interpret Medicaid policies for staff, assist in Medicaid training for staff and may review records to determine continuing Medicaid eligibility. Will assist and accompany clients through other agency eligibility determination processes. Will assist clients in hearings and appeal processes. Work requires use of personal initiative, extensive relationship building with other agency personnel and the ability to build trust and confidence with agency consumers.
Salary: $13.78
ESSENTIAL TASKS AND PURPOSES:- Obtain applications, screen and assist consumers in the Medicaid eligibility process.
- Schedule and conduct eligibility screening interviews with consumers
- Obtain and verify consumer Medicaid eligibility information, assist consumer in agency interviews
- Accompany consumer, if necessary to Medicaid eligibility interviews.
- Follow through on all Medicaid application to final determination, including the hearing process.
- Track, monitor and assist consumers throughout the Medicaid application process with other agencies
- Assist in preparation and in some cases, accompany the consumer to hearings and/or appeals
- Create Medicaid eligibility reporting system. Maintain complete record of activity.
- Enter data in a reporting system which identifies new, current and pending Medicaid applications.
- Track, record and report daily activities.
- Reports are submitted within established timeframes.
- Coordinate Medicaid eligibility information with appropriate program staff as well as reimbursement staff.
- Work closely with program staff to ensure efficient and effective flow of screening and interviewing. Keep program staff informed of eligibility activity.
- Maintain close contact with reimbursement staff regarding new Medicaid eligibility, ongoing eligibility, denials and appeals.
- Maintain excellent working relationships with all Medicaid related agencies.
- Develop and maintain cooperative, productive and diplomatic relationships with community, state and federal agencies, particularly those involved with Medicaid.
- Organize and manage workload effectively. Maintain absolutely confidentiality with consumers and other staff as appropriate.
- Meet Center and other agency deadlines involving Medicaid application timeliness, appeal/hearing timeframes and follow-up verification of information.
- Will follow rules and guidelines for confidentiality as established by supervisor and WTC requirements. There can be NO non-compliance's regarding this task. Employee must maintain a high level of professional confidentiality at all times.
- Transferring information only with clear consent to do so.
- Performs other duties as assigned
ESSENTIAL WORK BEHAVIORS:
All employees are
expected to comply with all West Texas Centers (WTC) Policies and Procedures.
This includes but is not limited to the following:
- WTC Code of Conduct Policy and reporting
requirements
- WTC Corporate Compliance Policy, related
procedures and reporting requirements
- Abuse, Neglect & Exploitation Policy and
reporting requirements
- Standards for Employees Policy
- Property and Equipment Policies and related
procedures
Staff
will establish and maintain effective work
relationships with individuals served and their families, supervisors,
co-workers, and visitors by demonstrating cooperative, courteous, and
respectful behavior. Staff will adhere to rules outlined in Confidentiality
Statement signed by employee and follow Information Services policy/ procedure
guidelines related to security and accountability as a user of WTC network and
software application technology.
All team members will promote and ensures safety
guidelines are followed for the work environment by maintaining clean, neat,
organized and safe work areas. This includes but is not limited to the
following:
- Safety concerns are reported to supervisor immediately
upon discovery and/or corrected.
- Identifies and reports any unsafe factors in
the environment.
- Reports and/or corrects safety hazards in the
work area.
- Utilizes universal precautions when handling
all blood and body fluids.
- Adheres to all standards, policies and
procedures of infection control.
- Universal precautions are utilized in
accordance to WTC policy and procedures.
Team Members must have and maintain a driving record that
is acceptable for insurability through the Center's insurance carrier. Staff must maintain a safe, inspected and
road-worthy vehicle and have a valid Texas Driver's License. Staff must notify
supervisor immediately of any driving violations or citations received from law
enforcement with no evidence of failure to report. Must meet the criteria that
indicate a commitment to safe and responsible driving as defined by the Texas
Risk Management Fund.