Peoples Health Centers Family of Companies

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Medicaid Resource Specialist

Hopewell Center-Downtown St. Louis | St. Louis, MO | Full Time

Job Description

About Us:

Amanda Luckett Murphy Hopewell Center grew out of a 30-year history of service. In 1988, Yeatman / Union-Sarah transferred its assets to Hopewell Center under the leadership of its founder, Dr. Amanda L. Murphy. In the fall of 2009, the board of directors of Hopewell Center elected to change the name of the organization to Amanda Luckett Murphy Hopewell Center to honor its founder and CEO. Incorporated as a not-for-profit 501(c)(3) since 1979, ALM Hopewell Center provides comprehensive mental health services to children and adults in the northern and central parts of the City of St. Louis and North St. Louis City. A professional mental health staff serves a growing caseload of 2,800 patients, of which greater than ninety-five percent are chronically mentally ill and suffering from major psychiatric disorders. Hopewell Center operates a Psychosocial Rehabilitation Center and a Comprehensive Psychiatric Rehabilitation Center for adults and youth. Many services are provided at schools. Emergency services, including a crisis bed and mobile outreach, are available twenty-four hours per day. A multi-disciplinary team of psychiatrists, psychologists, nurses, counselors, social workers, educators, and support staff work diligently to carry out the mission of providing comprehensive care to patients and their families.

SUMMARY OF DUTIES AND RESPONSIBILITIES:

The Resource Specialist is responsible for assuring adequate clerical staffing coverage, monitoring and reporting of Medicaid spend downs, training of Registration staff and following up with client eligibility.   

 

PRIMARY DUTIES AND RESPONSIBILITIES:

  Coordinates Medicaid applications with DFS workers; Tracks dates of applications and follows up. Reviews reports for Medicaid application re-application. Provides notification to CSS and managers that this is coming due to ensure people do not lapse. Troubleshoots Medicaid rejections and spend-down rejections and ensures action is taken to help address the problems. Monitors client eligibility reports to proactively assist clients in re-applying for Medicaid. Reviews reports and follows up with clients in the Rehab programs who have high levels of POS billing. Provide follow-up for on-site Medicaid spend downs by giving a printout of all cost incurred through Hopewell Center and Omni-Care Pharmacy to DFS worker. Assist clients with obtaining any billing information from outside DFS agencies to support spend-down process. Assist client with Medicaid application process. Development and distribution of reports to monitor progress and/or problems. Oversight of the registration process (as it pertains to fund sources and data entry), and assurance of accurate completion of all required paperwork. Ensures that the errors on the billing reports get corrected for both Pershing and People’s.   Provides education to staff when there are multiple errors.  Assures that front desk procedures run smoothly, and that personnel support customer satisfaction. Conducts formal training and informal follow-up to assure accuracy of data entry by registration and front desk staff as it pertains to program entry and fund sources. Runs reports monthly that allow us to determine if registration forms are entered correctly based on types of rejections identified.  Cross-trains other staff who function as back-up to front desk and registration roles. Attends staffing and provides regular reporting to staff on spend-down needs; Informs supervisors of monthly status of spend-down being met.  Provides training and education to new staff on spend-down and Medicaid issues and compliance. Other duties as assigned.
 
People's Family of Corporations does not discriminate on the basis of race, creed, color, ethnicity, national origin, religion, sex, sexual orientation, gender expression, age, height, weight, physical or mental ability, veteran status, military obligations, and marital status