Medicaid Eligibility Specialist

Job Description

Davis Behavioral Health (DBH) is actively recruiting a full-time Medicaid Eligibility Specialist to join its finance team.

The Medicaid Eligibility Specialist is responsible for receiving and working the daily eligibility files received from Utah Medicaid and verifying that DBHs Electronic Health Record (EHR) has current and correct information. If that information is incorrect they are responsible for updating it in the EHR contacting the client and letting them know if there is an issue finding out if assistance is needed and working with the case management staff to assist the client in getting Medicaid back. They also work with the billing department to make sure the account is correct.

Eligibility is checked for all Fee for Service Medicaid clients and Expansion Medicaid Clients monthly.

Essential Job Functions

The Medicaid Eligibility Specialist Is responsible for performing the following essential job functions at the expected level and within the expected timeframes:

• Running and working 834 eligibility files.
• Updating payer information in DBHs electronic health record (Credible) as needed.
• Contacting clients and explaining changes in eligibility.
• Other duties and responsibilities as needed and assigned.

Position-specific Job Functions

In addition to the essential job functions outline above the following responsibilities are assigned to your specific position:

• Contacting clients and explaining changes in Medicaid eligibility and working with case management staff to help clients re-enroll with Medicaid.
• Working Medicaid pre-billing error reports.
• Entering inpatient services for billing Medicaid.
• Other duties and responsibilities and needed and assigned.

Employment Classification and Schedule

This position is classified as full-time non-exempt 40 hours per week.

The proposed schedule for this position is Monday through Friday from 8:00 am to 4:30pm with a 30-minute lunch.

DBH reserves the right to require occasional overtime weekend work and/or assignments to evening or night shifts.

Location & Work Environment

The finance office is located in the DBH Main Street Clinic located at 934 South Main Street Layton UT 84041.

The noise level may vary depending upon the daily activities within the work environment such as the number of people in the office. The work environment is frequently interrupted as the employee must meet multiple demands from many people. The employee must constantly work to meet deadlines.

Compensation

The hourly rate for this position is outlined below:

• $18.00 per hour

All new employees at DBH have a 6-month introductory period to assess whether they can perform the essential functions of the job at the expected level within the specified timeframes and are a good fit for the job.

Required Qualifications

The Medicaid Eligibility Specialist must possess the following qualifications skills and abilities to successfully perform the essential functions of the job:

The successful candidate must be at least 18 years old.

Experience

• Previous experience working in a professional office setting is required.
• A working knowledge and previous experience with Medicaid enrollment is also strongly preferred.

Education

• High school diploma or equivalent is required.

Training

• Complete all required training that is assigned to the Medicaid Eligibility Specialist position by defined deadlines.

Skills/Abilities/Qualifications

• Computer literacy including keyboarding (typing) skills.
• Possess proficient working knowledge of Microsoft Office Suite and other computer programs.
• Strong communication skills both verbal and written are required.
• Ability to work both individually and as part of a team and with staff in multiple departments across DBH is requried.
• Fluency in both English and Spanish is helpful but not required.

The selected candidate must successfully pass a pre-employment criminal background check and drug screening. DBH will not hire individuals currently using illegal drugs or abusing alcohol; therefore making employment at DBH conditional upon successfully passing pre-employment drug screening by providing a valid sample. Candidates who are offered employment are required to report for a drug screen at an Intermountain WorkMed location within 24 hours of being requested to do so by the DBH Human Resources Department.

Davis Behavioral Health works with Federal grants and must comply with the Federal drug laws including no use of medical marijuana.

Benefits

Davis Behavioral Health Inc. offers an incredible valuable and comprehensive benefits packages to eligible employees. A copy of the current DBH Benefits Guide is available upon request.

DBH benefits include:

Medical Insurance - The current carrier and network is SelectHealth Share.

• High Deductible Health Plan with a sizeable employer Health Savings Account contribution. H.S.A. administered by HealthEquity.

Dental Insurance - The current carrier and network is Delta Dental.

Integrated Primary Care Clinic - Nice Healthcare. Every day care whenever you need it.

Vision Insurance - Offered by VSP

Flexible Spending Account (FSA) - Administered by APA Benefits.

• Annual healthcare spending limit: $3300
• Annual dependent care spending limit: $5000

Retirement

• Utah Retirement System participating agency
• 401(k) - DBH matches up to 2% of annual earnings
• Voluntary employee-funded options available (457 Plan Roth IRA)

Life and Accidental Death and Dismemberment Insurance - Administered by USAble.

• Basic Life and AD&D Benefit Amounts
• Employee:2x your base annual earnings rounded to the nearest $1000 to a maximum of $300000
• Spouse: $10000
• Child(ren): $5000 on each eligible dependent child
• Voluntary Life and AD&D Insurance

Long-term Disability - Administered by USAble.

Health Reimbursement Account (H.R.A.) - Offered to employees to voluntarily opt out of DBH medical insurance. Administered by APA Benefits.

Up to $2600 per year contributed by DBH after required employee contribution.

Voluntary Insurance - Administered by Assurity.

• Voluntary Accident
• Voluntary Critical Illness
• Voluntary Hospital Indemnity

Voluntary Identify Theft Protection - Administered by Allstate Benefits.

Employee Assistance Program (EAP) - Administered by Intermountain Healthcare.

Davis Behavioral Health is an equal opportunity employer.

DBH Criminal Background Check & Drug Screening Disclaimer

Davis Behavioral Health is a drug-free workplace and requires all employees to successfully pass a pre-employment drug screening. DBH will not hire individuals currently using illegal drugs or abusing alcohol; therefore making employment at DBH conditional upon successfully passing pre-employment drug screening by providing a valid sample. Candidates who are offered employment are required to report for a drug screen at an Intermountain WorkMed location within 24 hours of being requested to do so by the DBH Human Resources Department.

Davis Behavioral Health works with Federal grants and must comply with the Federal drug laws including no use of medical marijuana.

Further all employees at DBH must successfully pass a pre-employment criminal background check as part of DBHs licensing agreement with the State of Utah. Failure to pass either screening will result in the termination of any job offer submitted and/or employment for any individual who has started employment while the criminal background screening is in process. Pending and/or open charges will likely impact a candidates ability to pass the pre-employment criminal background screening.

Required Experience:

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