Eligibility & Financial Determination Specialist PACE

Aurora, CO - USA

Monthly Salary: $ 19 - 22

Posted on: 13 hours ago

Vacancies: 1 Vacancy

Job Summary

Colorado PACE has an opening for an Eligibility & Financial Determination Specialist.

Location:Aurora CO

Status: Full-time

Schedule: Monday-Friday 8-5

Hourly Pay Range: $19.29 - $22.50

Supplemental Pay:Based on position schedule and/or availability:Overtime

Mileage and Expense Reimbursement:Sixty-two and a half cents per mile one of the highest in the industry!

CULTURE BENEFITS AND PERKS:

We value engagement community and outreach initiatives and know it matters for our team members and our patients. We provide welcoming and supportive care to our patients and a work environment where all team members feel respected and valued.
We support a culture of work-life balance and provide team members with two free confidential and robust benefit programs designed to provide solutions to the logistical and financial problems that arise in life.
Low healthcare premiums: we have not increased our team member medical rates 4 out of the last 5 years
Employer pays over 90% of employee medical premium in some plans
Health Savings Account (HSA) with significant Employer Funding: Single $1000 Family $2000
Healthcare Benefits are effective on the 1st of the month following date of hire
Extensive Paid Time Off (PTO/Vacation Pay/Sick Leave) and EIB (Extended Illness Bank): 18 days in the first year for FT team members
Seven Paid Holidays with an additional Floating Holiday
403(b) Retirement Plan with Employer Match: 50% match up to 8% of total compensation
Company-Paid Life and AD&D Insurance
Career & Logo wear
Education Reimbursement Program
Clinical Career Ladders
Certification Pay
Generous Discover-a-Star Team Member Referral Program
Team Member Service Awards
Early Wage Access
Legal and Identity Protection
Robust Leadership Development Training Programs

REWARDING WORK YOU WILL DO:

Administration & Compliance (80%)

Reviews/prepares Medicaid applications and partners with the Enrollment Team and PACE Interdisciplinary Team (IDT) to obtain all required financial and personal documentation needed for timely eligibility decisions.
Serves as the primary point of contact regarding Medicaid application processes best practices and ongoing training.
Maintains a tracking system for all submitted applications from initial submission through approval providing regular updates to the Director of Business Development PACE Center Director(s) and PACE Executive Director.
Ensures all applications comply with Colorado Medicaid rules and regulations including updates to Health First Colorado Long-Term Care (LTC) Medicaid Spousal Impoverishment provisions Trusts Old Age Pension (OAP) and related Medicaid programs applicable to PACE participants.
Collaborates with Accounts Receivable to monitor and resolve monthly Medicaid-related issues for PACE participants.
Monitors private pay participants and supports seamless transitions to Medicaid eligibility when appropriate.
Ensures all eligibility staff maintain current knowledge of Medicaid policies and application processes.
Responds promptly to adverse action notices including 10-day notices denials and requests for additional information from County Human Services.

Participant Eligibility Support (20%)

Troubleshoots complex eligibility cases in partnership with Enrollment Team and IDT.
Provides regular updates to Director of Business Development PACE Center Director(s) and PACE Executive Director on application status assisting with questions barriers and required follow-up.
Collaborates with County Human Services Social Workers Intake and PACE interdisciplinary teams to resolve eligibility financial classification and documentation issues.
Demonstrates leadership by modeling professionalism providing guidance and supporting positive morale and teamwork within the Enrollment team.

WHAT WE ARE GOING TO LOVE ABOUT YOU:

Minimum Education: High School Diploma or equivalent
Minimum Experience: Prior experience working with the frail and elderly population in a healthcare setting. 2 years experience in Medicaid eligibility financial determination or benefits coordination. 1 year experience working with CMS and strong knowledge of Colorado Medicaid Benefits.
Required License: Valid Colorado Drivers License and proof of auto insurance.

PHYSICAL REQUIREMENTS:

Ability to lift/carry a minimum of 30 lbs

Colorado PACE is affiliated with Care Synergy a nonprofit network of community-based hospice and palliative care organizations serving Colorados Front Range and the Regions Largest Home Health Hospice and Palliative Care Network. Care Synergy provides mission support services to better equip Colorado PACEto operate as a distinct and independent organization while working together to share best practices and serve more Coloradans along the Front Range.

If you need assistance completing the electronic application please contact our Talent Acquisition team via email at You may also call the Human Resources Department at . Applications can be completed in-person at any one of our affiliate office locations.

The Organization does not discriminate in employment opportunities or practices on the basis of race color religion gender gender identity pregnancy national origin age disability creed ancestry genetic information marital status sexual orientation/identity transgender status military or veteran status or any other characteristic protected by federal state or local law. This prohibition includes unlawful harassment based on any of these protected classifications.

Required Experience:

Colorado PACE has an opening for an Eligibility & Financial Determination Specialist.Location:Aurora COStatus: Full-timeSchedule: Monday-Friday 8-5Hourly Pay Range: $19.29 - $22.50Supplemental Pay:Based on position schedule and/or availability:OvertimeMileage and Expense Reimbursement:Sixty-two and ...