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Member Retention Associate

Company: Harbor Health Services
Location: Brockton
Posted on: January 16, 2019

Job Description:

The Member Retention Associate is primarily responsible for ensuring that the annual MassHealth Re-determination Applications are complete for all new and existing PACE Participants. Duties include working directly with participant and family members, along with various departments in ESP and MassHealth, gathering necessary documentation for participants transitioning to Long Term Care (LTC), working with Financial Claims Coordinator in determining Patient Paid Amounts (PPAs). Essential Functions:

  • Works with Social Work and contracted Nursing Home Business Offices to gather needed documentation and facilitates smooth transition to Long Term Conversions and PPA compliance.
  • Establishes and monitors the PPA dollar amount for participants in institutional facilities.
  • Establish and maintain an on-going schedule of re-determinations based on initial participant Medicaid enrollment date.
  • Coordinate collection of required documents (from participant/family/bank, etc.) and ensure submission to the State.
  • Interacts with participants and caregivers in a manner that adheres to the highest standards of care and professionalism.
  • Builds and maintains relationships with Medicaid EOHHS Departments to ensure that all ESP participants' Medicaid applications are processed correctly and in a timely manner.
  • On a monthly basis update and issue the Monthly Participant List and distribute as directed.
  • Play key financial role in Enrollment process.
  • Meet with participant and family members to review financial components of Enrollment.
  • Ensure that participant and family members complete Income Verification forms. Required Education, Experience and Skills:
    • Bachelor's Degree.
    • Intermediate or higher skill set in Microsoft Word and Excel.
    • Two years of experience in a professional office setting.
    • Financial experience working with Medicaid.
    • Experience working with MassHealth.
    • Proven problem solving skills.
    • Excellent verbal and written communication skills.
    • Excellent customer service skills
    • Must be able to timely travel between all Harbor sites and work occasional evenings. Harbor Health is an Equal Opportunity Employer M/F/V/D.

      Keywords: Harbor Health Services, Brockton , Member Retention Associate, Other , Brockton, Massachusetts

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