Job Description
Description CRi is a well-known non-profit organization located throughout
Northern VA, Richmond VA , and
Maryland that is dedicated to providing quality services to enable individuals with a wide range of disabilities to live as independently as possible.
We are hiring an
Administrative Social Worker to coordinate, manage, and oversee the Virginia Medicaid redetermination process for individuals enrolled in ICF/IDD services. The Administrative Social Worker will:
- Act as CRi's point of contact for local Department of Social Service agencies.
- Access the Virginia Medicaid web portal to ensure continuity of Medicaid coverage and accurate assessment of patient copays based on total resources.
- Monitor additional entitlements, such as pensions and trusts, and acts as CRi's point of contact for income source.
- Act as liaison between CRi's clinical and financial departments to ensure effective flow communication.
- Collaborate with the PFA analysts, monitors PFAs to ensure funds do not exceed allowable resource limits and supports clinical managers as necessary with developing spending plans.
Principal Duties and Responsibilities: Management of Medicaid, Social Security, and Other Benefits - Develops and implements systems to monitor and manage authorization of Medicaid and Social Security benefits.
- Works with DSS office representative to ensure timely completion of Medicaid Redetermination forms and submission of supporting documentation.
- Communications patient pay information with PFA Analyst monthly and at the time of adjustments.
- Managers copay adjustments for allowable costs and follows process through to completion, maintaining communication with the Program Manager and PFA Analyst.
- Collaborates with PFA Analyst to monitor PFAs to ensure compliance with resource limits.
- Acts as agency identified Social Security Representative Payee, following policy and completing all required documentation.
- Leads process in Social Security appeals when necessary.
- Documents individuals' private health insurance and adjusts Medicaid processes accordingly.
- Monitors Medicare coverage and reviews EOBS.
- Provides support to the Program Managers/Nurses with DME purchases, specifically as it relates to Medicaid and Medicare coverage.
- Completes monthly reviews of income, resources and copay responsibility and reports data to the Director of Admissions and Social Work in monthly metrics.
- Manages assigned caseload and additional cases as necessary.
Records Maintenance: - Ensures all relevant authorization documents are attached in the individuals' EHR.
Schedule: M-F varies (40hrs)
Locations: This position supports 4 programs in the following locations: Vienna, Annandale, Springfield, and Alexandria.
Compensation: $44,761.60/yr
Requirements Minimum Qualifications: - Bachelor of Social Work and 1 year of experience providing administrative social work functions.
- Demonstrates knowledge of Medicaid and Social Security systems.
- Proficient in all office equipment, such as use of telephone system, copier, printer, scanner, facsimile, postage, and teleconference set-up.
- Valid driver's license with a good driving record.
Physical Demands: - Must be able to sit for extended periods of time and lift up to 15 pounds.
CRi offers company-paid benefits including health insurance options, 403(b) retirement fund, and life insurance for benefits-eligible employees!
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Job Tags
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