13 days old

Presumptive Eligibility Coordinator Rep

AtlantiCare Regional Medical Center
Egg Harbor, NJ 08232
  • Job Code
    114150191
AtlantiCare Regional Medical Center

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.


Egg Harbor Twp, NJ

POSITION SHIFT: Days

POSITION STATUS: Full-Time

REQ_NUM: 10-24607

Department: Crisis Mobile Response

Hours Per Week 37.5

Holidays Required? No

Job Category: Behavioral Health

Location: Egg Harbor Twp

Weekends Required? No


POSITION SUMMARY

Reports To: Unit Director

Trainings: Annual Cyber Training

Position Summary: The Presumptive Eligibility (PE) /3560 Coordinator is responsible for ensuring that all youth receiving services from CMRSS have submitted a completed PE application if they do not have Medicaid coverage at dispatch . The PE /3560 Coordinator is responsible for collaborating with CIS, program coordinators and program director to ensure that any barriers to completing a PE application or Medicaid documentation are completed in full in a timely manner

Duties and Responsibilities:
  • Coordinator maintains accurate insurance files/spread sheet for all applications submitted, up- dating status pending approval and actions taken to resolve problems w/NJFC and Medicaid units to ensure appropriate medical coverage is secure w/i 30 days.
  • Demonstrates responsibility for representing Atlanticare CMRSS at all state Medicaid unit meetings and CSOC Medicaid PE/3560 coordinator reporting meetings updates and make appropriate recommendations and provide feedback to CMRSS Program Director.
  • Develops positive working relationships with all CIS staff to coordinate collecting all necessary documents and with local and state PE entities and Medicaid staff as well as the AtlantiCare Billing Dept.
  • Upholds the policy and procedures of Atlanticare and CMRSS, completes all state required trainings and completes all other duties as assigned. T
  • Completes all Cyber trainings provided by the state and will be responsible for entering and monitoring financial and authorization related information into the Cyber system.
  • Coordinates with the MRSS Director and the QI Coordinator before inputting insurance guarantor and authorization information into the Avatar database and entering MRSS service charges as required.
  • Provides support to the Intensive In Community (IIC) program by registering new clients into the Star Navigator database and entering insurance and authorization information into Avatar.
  • Reviews and submits IIC staff timesheets and cross referencing this information with progress notes and service delivery forms to ensure consistency and accuracy of hours delivered.
  • Enters ongoing authorizations.
  • Manages Medicaid denials and communication with ABH CBO.

Minimal Qualifications:

Education: High School Diploma or equivalent.

Experience: Minimum 1 year experience preferred. Strong customer service skills, math skills and proficient in Microsoft Excel required. Proficient with other Microsoft Office applications required. Bilingual preferred.

Equipment Use: Computer, Lap Top, and Calculator.

The above statement reflects the general details considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent in the position

PI114150191

<b>AtlantiCare Regional Medical Center</b><br/><br/>All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.<br/><br/><br/>Egg Harbor Twp, NJ<br/><br/><b>POSITION SHIFT: </b>Days<br/><br/><b>POSITION STATUS: </b>Full-Time<br/><br/><b>REQ_NUM: </b>10-24607<br/><br/><b>Department: </b>Crisis Mobile Response<br/><br/><b>Hours Per Week </b>37.5<br/><br/><b>Holidays Required? </b>No<br/><br/><b>Job Category: </b>Behavioral Health<br/><br/><b>Location: </b>Egg Harbor Twp<br/><br/><b>Weekends Required? </b>No<br/><br/><br/><STRONG>POSITION SUMMARY</STRONG><br><br><STRONG>Reports To: </STRONG>Unit Director<br><br><STRONG>Trainings: </STRONG>Annual Cyber Training<br><br><STRONG>Position Summary: </STRONG>The Presumptive Eligibility (PE) /3560 Coordinator is responsible for ensuring that all youth receiving services from CMRSS have submitted a completed PE application if they do not have Medicaid coverage at dispatch . The PE /3560 Coordinator is responsible for collaborating with CIS, program coordinators and program director to ensure that any barriers to completing a PE application or Medicaid documentation are completed in full in a timely manner<br><br><STRONG>Duties and Responsibilities:</STRONG><br><UL><LI>Coordinator maintains accurate insurance files/spread sheet for all applications submitted, up- dating status pending approval and actions taken to resolve problems w/NJFC and Medicaid units to ensure appropriate medical coverage is secure w/i 30 days.</LI><LI>Demonstrates responsibility for representing Atlanticare CMRSS at all state Medicaid unit meetings and CSOC Medicaid PE/3560 coordinator reporting meetings updates and make appropriate recommendations and provide feedback to CMRSS Program Director.</LI><LI>Develops positive working relationships with all CIS staff to coordinate collecting all necessary documents and with local and state PE entities and Medicaid staff as well as the AtlantiCare Billing Dept.</LI><LI>Upholds the policy and procedures of Atlanticare and CMRSS, completes all state required trainings and completes all other duties as assigned. T</LI><LI>Completes all Cyber trainings provided by the state and will be responsible for entering and monitoring financial and authorization related information into the Cyber system.</LI><LI>Coordinates with the MRSS Director and the QI Coordinator before inputting insurance guarantor and authorization information into the Avatar database and entering MRSS service charges as required.</LI><LI>Provides support to the Intensive In Community (IIC) program by registering new clients into the Star Navigator database and entering insurance and authorization information into Avatar.</LI><LI>Reviews and submits IIC staff timesheets and cross referencing this information with progress notes and service delivery forms to ensure consistency and accuracy of hours delivered.</LI><LI>Enters ongoing authorizations.</LI><LI>Manages Medicaid denials and communication with ABH CBO.</LI></UL><br><STRONG>Minimal Qualifications:</STRONG><br><br>Education: High School Diploma or equivalent.<br><br>Experience: Minimum 1 year experience preferred. Strong customer service skills, math skills and proficient in Microsoft Excel required. Proficient with other Microsoft Office applications required. Bilingual preferred.<br><br><STRONG>Equipment Use:</STRONG> Computer, Lap Top, and Calculator.<br><br>The above statement reflects the general details considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all work requirements that may be inherent in the position<br><br><br/><br/> <img src="https://analytics.click2apply.net/v/QljABdHeZJAGUV65ioLBQ"> <p>PI114150191</p>

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Posted: 2019-10-01 Expires: 2019-11-01

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Presumptive Eligibility Coordinator Rep

AtlantiCare Regional Medical Center
Egg Harbor, NJ 08232

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