CEA Medicaid Case Manager-Atlanta GA
Chamberlin Edmonds - Atlanta, GA

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This position is responsible for providing high quality client focused service by using knowledge of local, state and federal program requirements to efficiently maintain and update general applicant information, financial, medical and personal information to support client applications.
• Documents and updates the PACE (Patient Advocacy at Chamberlin Edmonds System) based on daily contact of select members of assigned applicant group and application evidence requirements, i.e. work activity, medical condition, third party, beneficiary, contact and demographic data financial, life and health insurance information, employment and salary verification, medical history and documentation where evidence is required.
• Reviews inbox for daily work queues, identifies missing evidence and follows through to completion
• Answers incoming calls from clients and Health Care Representatives
• Assists callers in resolving account issues by identifying and taking appropriate actions including completing required forms to support application process
• Effectively educates and answers inquiries from patients and family representatives regarding application process
• Assists clients with scheduling appointments and reminding of appointments, as needed
• Maintains ongoing communication with other internal Resolve Application functions to obtain information and/or provide updates regarding claim status
• Identifies and takes appropriate actions to complete and submit required financial, medical and personal information forms to support the client application process
• Reviews software system for document mailings prior to applications, medical records, etc. is packaged and mailed to external sources
• Receives calls and assists clients, company representatives and Healthcare Reps in resolving evidence application issues
• Diligently follows-up with institutions/businesses resolving issues ultimately affecting application approval
• Identifies appropriate escalation points and works with Escalation Team Leader to resolve issues
• Reviews outgoing client material for accuracy prior to submittal
• Complies with ethics, privacy and compliance policies and procedures
•Associates Degree
•Knowledge of Georgia Family Medicaid programs (LIM, RSM, AMN, EMA) and/or federal SSI/SSDI disability application processes and programs
•Previous case management experience
•Knowledge of medical terminology
•Previous customer service experience, preferably in a busy call center environment
•Strong and demonstrated verbal and written communication skills
•Demonstrated experience working with people of various educational and socioeconomic backgrounds
•Proficient computer skills in Microsoft products: Outlook, Word, Excel
•Strong organizational skills including the ability to prioritize, plan and follow through
•Professional and courteous phone demeanor
•Skill in identifying problems as well as researching and recommending solutions
•Bachelor’s Degree, preferably in Social Work, Psychology or Business
•Experience communicating with government case workers and/or hospital personnel
•Fluency in both English and Spanish languages
•Previous experience in a health care environment
•Previous experience working for Social Security Administration (SSA) and/or Disability Determination Services (DDS)