medicaid eligibility specialist

Revenue Group

<div>Description:

Start Date: Immediately
Pay: $13.50-$14.50 an hour based on experience plus monthly bonus up to $300 after 90 days
Hours: Monday - Friday 8:00am &ndash; 4:30pm (With a half hour lunch) and 2 company paid 15 min breaks
*This position is remote upon completion of 4 weeks of training on site in Cleveland office! *
**You MUST have internet speed of 100MBps** 
Who is Hospital Referral Services? 
No one wakes up in the morning and says, &quot;Today I want to go to the hospital&quot;. We are here to help when the unexpected happens. Hospital Referral Services Hospital Insurance Representative will help patients via phone to see what assistance programs the uninsured or underinsured may be eligible to receive. 
 
We are looking for self-motivated professional to add to our growing team. If helping people is something you enjoy, this may be the right job for you.
HRS's team of experts helps guide patients through the Medicaid process so the patient can focus on recovery.
Our employees voted us Top Workplaces 4 years in a row!
The Outpatient Medicaid Eligibility Representative will be responsible for:<ul><li>
Screening/Interviewing patients for insurance eligibility in outbound dialer environment</li><li>
Providing thorough, efficient, and accurate documentation.</li><li>
The Outpatient Medicaid Eligibility Representative is responsible for meeting goals and quality standards through efficient and accurate work activities.</li></ul>
PM21
Requirements:

Work Requirements:<ul><li>
1-3 years Dialer call center environment preferred &ndash; not required (minimum of 60 calls daily)</li><li>
1-3 years of previous healthcare eligibility experience preferred-not required</li><li>
Ability to maintain the highest level of confidentiality, customer service, and knowledge of HIPAA.</li><li>
Proficient personal computer skills including Microsoft Office &ndash; able to type at least 40 WPM</li><li>
The Outpatient Medicaid Eligibility Screener must have the ability to multi-task and have good time management skills.</li><li>
High School Diploma or equivalent (GED)</li><li>
7-year background check</li></ul>
Training for the Outpatient Medicaid Eligibility Representative:<ul><li>
In office training will include HIPAA regulations, Revenue Group procedures, Medicaid eligibility, role-playing, client systems and procedures.</li><li>
In office floor training: This will include observation of veteran representatives and supervised calls.</li></ul>
Our Benefits:<ul><li>
100% Paid Training</li><li>
401(k) matching</li><li>
Paid Time off (PTO) &ndash; Up to 10 days your first year!</li><li>
8 Paid Holidays &ndash; Including your birthday!</li><li>
Referral Program</li><li>
Employee Assistance Program (EAP)</li><li>
Growth &amp; Continued Training</li><li>
Dental &amp; Vision insurance</li><li>
Health insurance (including Long &amp; Short-Term Disability)</li><li>
Life insurance (Company Paid)</li></ul>
EEO Statement: 
We are an Equal Employment Employer. We do not discriminate in hiring on the basis of sex, gender identity, sexual orientation, race, color, religious creed, national origin, physical or mental disability, protected Veteran status, or any other characteristic protected by federal, state/province, or local laws.
PM21</div>

Outpatient Medicaid Eligibility Representative

The Groves

<div>Job Title: Medicaid Specialist &ndash; Long-Term Care Facilities

About Us: 
We are a skilled nursing and rehabilitation facility committed to delivering exceptional care to our residents. We&rsquo;re looking for a detail-oriented and knowledgeable Medicaid Specialist to join our business office.

Position Overview: 
The Medicaid Specialist plays a critical role in supporting the financial and administrative functions of our facility. This position will focus on managing Missouri Medicaid applications, redeterminations, and compliance for long-term care residents. It is ideal for someone with experience in a Business Office Manager or Assistant BOM role who has a strong background in Medicaid processes.

Key Responsibilities:
<ul>
<li>Oversee and manage all aspects of the Missouri Medicaid application and approval process
</li>
<li>Assist residents and families in gathering and submitting required documentation
</li>
<li>Monitor Medicaid redetermination timelines and ensure continued coverage
</li>
<li>Collaborate with the business office manager and admissions team to verify payor sources and maintain accurate records
</li>
<li>Communicate effectively with DSS caseworkers, legal representatives, and residents&rsquo; families
</li>
<li>Maintain compliance with state and federal regulations
</li>
</ul>Qualifications:
<ul>
<li>Previous experience in a long-term care facility business office required
</li>
<li>Strong knowledge of Missouri Medicaid regulations and LTC eligibility requirements
</li>
<li>Excellent communication, organization, and follow-up skills
</li>
<li>Ability to work independently and as part of a team
</li>
<li>Proficiency in Microsoft Office and electronic health record systems
</li>
</ul>BOM &ndash; Business Office Manager Benefits:
<ul>
<li>Competitive salary
</li>
<li>Great work environment
</li>
<li>Medical, Dental &amp; Vision Benefits
</li>
<li>Vacation, Sick &amp; Holiday Pay</li></ul></div>

Billing Assistant BOM

Piedmont Retina Specialists

Job Title: Billing and Collections Specialist Location: Greensboro, NC Practice Type: High-Volume Ophthalmology Practice Employment Type: Full-TimeOverview: Our well-established retina ophthalmology practice in Greensboro, NC is seeking a detail-oriented and experienced Billing and Collections Specialist to join our dynamic team. This role requires a strong background in medical billing specific to ophthalmology, with a focus on Medicare, Medicaid, and commercial insurance plans. The ideal candidate is not only technically proficient but also empathetic and professional when working with patients&mdash;especially our elderly population.Key Responsibilities:<ul><li>Accurately process and manage billing for a high-volume ophthalmology practice</li><li>Ensure proper coding with ICD-10 and CPT, with a focus on ophthalmologic procedures</li><li>Handle insurance verification, prior authorizations, and eligibility checks</li><li>Manage patient collections with a courteous and compassionate approach</li><li>Address patient billing inquiries clearly and effectively</li><li>Work collaboratively with clinical and administrative teams to resolve billing discrepancies</li></ul>Qualifications:<ul><li>Minimum 2 years of experience in medical billing and collections, preferably in ophthalmology/retina</li><li>Proficient in ICD-10, Medicare/Medicaid billing guidelines, and EMR systems</li><li>Strong understanding of insurance policies including Medicare Advantage and NC Medicaid</li><li>Excellent organizational, communication, and problem-solving skills</li><li>Ability to maintain a professional and kind demeanor, especially with elderly patients</li><li>Dependable and punctual, with a strong work ethic and attention to detail</li></ul>Preferred Traits:<ul><li>Team Player: Willing to collaborate and assist where needed</li><li>Excellent Communicator: Able to understand and convey information clearly</li><li>Highly Reliable: Consistently punctual and committed to quality patient care</li><li>Positive Attitude: Displays grace, patience, and kindness in all interactions</li><li>Self-Starter: Proactively takes initiative and uses time efficiently</li></ul>Compensation &amp; Benefits:<ul><li>Competitive salary based on experience</li><li>Health insurance (company-sponsored) after 90 days</li><li>Paid holidays</li><li>3 weeks of paid vacation per year</li><li>401(k) with company match after one year</li><li>Bonus structure available after one year of employment</li></ul>Job Type: Full-timePay: $22.00 - $25.00 per hourBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Health insurance</li><li>Paid time off</li></ul>Work Location: In person

Billing and Collections Representative

Mac Care

We are seeking a detail-oriented and analytical Insurance Verification &amp; Eligibility Specialist to join our Revenue Cycle team. The ideal candidate will be responsible for verifying patient insurance coverage, determining eligibility, obtaining prior authorizations, and ensuring accurate documentation to support timely claim submission and payment. This role is critical in reducing claim denials, accelerating reimbursements, and supporting overall financial performance in a U.S. healthcare environment.Key Responsibilities: Insurance Verification &amp; Eligibility:<ul><li>Verify patient insurance coverage (commercial, Medicare, Medicaid, and other payers) prior to appointments or services.</li><li>Confirm benefits, deductibles, co-insurance, co-payments, policy limitations, and exclusions.</li><li>Review and interpret payer portals, EHR systems, and clearinghouses for real-time eligibility updates.</li><li>Ensure accurate documentation of verified benefits in the system.</li></ul>Authorization &amp; Pre-Certification:<ul><li>Obtain prior authorizations as required by payers for specific procedures, diagnostic tests, or treatments.</li><li>Communicate with insurance companies to resolve authorization discrepancies or incomplete information.</li><li>Track authorization status and follow up to secure approvals before service dates.</li></ul>Communication &amp; Coordination:<ul><li>Coordinate with providers, schedulers, and billing teams to ensure all insurance-related requirements are met prior to patient appointments.</li><li>Communicate coverage issues, payer requirements, or eligibility concerns to relevant teams promptly.</li><li>Provide guidance to patients regarding coverage expectations, if required.</li></ul>Documentation &amp; Data Accuracy:<ul><li>Maintain complete and accurate patient insurance information in the practice management or billing system.</li><li>Document all interactions, verification results, and authorization details in compliance with organizational policies.</li><li>Identify and correct missing or outdated insurance information.</li></ul>Denial Prevention &amp; RCM Support:<ul><li>Identify potential coverage issues that may result in claim denials.</li><li>Work closely with AR and Billing teams to support clean claim submission.</li><li>Review denial trends related to coverage or eligibility and provide feedback to the team.</li></ul>Qualifications &amp; Requirements:Education:<ul><li>Bachelor&rsquo;s degree preferred, but not mandatory.</li><li>High school diploma or equivalent required.</li></ul>Experience:<ul><li>1&ndash;2 years of experience in U.S. Healthcare Revenue Cycle Management (Insurance Verification, Eligibility, Front-End RCM).</li><li>Experience with commercial insurances, Medicare, Medicaid, and managed care plans preferred.</li><li>Familiarity with EMR systems, clearinghouses, and payer portals.</li></ul>Job Type: Full-timeWork Location: In person

Insurance Verification-Eligibility Specialist

St. Paul's Senior Living Community

About the Role: We are seeking a detail-oriented Nursing Care Billing Specialist to manage end-to-end resident billing and accounts receivable functions for our on-site skilled nursing facility. This role covers Medicare, Medicaid (Medical Assistance), Medicare Advantage/Managed Care, commercial insurance, Long-Term Care insurance, and private pay. You will use MatrixCare as the primary electronic health record (EHR) and billing platform, ensuring accurate claim submission, timely collections, regulatory compliance, and seamless coordination with clinical, admissions, and finance teams.Key Responsibilities:Revenue Cycle &amp; Claims Management<ul><li>Prepare, submit, and monitor skilled nursing home claims for:</li><li>Medicare Part A and Part B</li><li>Medicare Advantage (MA) / Managed Care Organizations (MCOs)</li><li>Medicaid (Medical Assistance)</li><li>Commercial and supplemental insurance</li><li>Long-Term Care insurance</li><li>Private pay residents</li><li>Generate, review, and submit claims using MatrixCare billing and financial modules, clearinghouses, and payer portals in compliance with CMS and payer-specific requirements.</li><li>Validate resident, payer, and charge data within MatrixCare prior to claim submission to ensure billing accuracy and compliance.</li><li>Track claim status, resolve rejections and denials, submit corrected claims, and complete appeals with appropriate clinical and financial documentation.</li><li>Ensure accurate coordination of benefits (COB) and secondary payer billing within MatrixCare and payer systems.</li></ul>Admissions, Eligibility &amp; Authorizations<ul><li>Review admissions, discharges, payer changes, and level-of-care/status changes daily using MatrixCare census and payer reports.</li><li>Verify Medicare Part A skilled coverage eligibility, available benefit days, and benefit exhaustion dates at admission and throughout the stay.</li><li>Obtain, document, and maintain all required prior authorizations, continued stay reviews, and eligibility verifications for Medicare Advantage, Medicaid, and managed care plans.</li><li>Enter benefit, authorization, and coverage notes into MatrixCare for interdisciplinary visibility.</li><li>Participate in interdisciplinary admissions, Medicare, and managed care meetings to remain current on resident coverage and care status.</li><li>Maintain and distribute accurate daily census and payer mix reports to internal departments and contracted service providers as required.</li></ul>Medicaid (Medical Assistance) Billing &amp; Compliance<ul><li>Prepare and submit Medicaid (Medical Assistance) claims and supporting documentation in accordance with federal and state regulations.</li><li>Maintain organized and current Medicaid eligibility records, including benefit cards, authorization notices, and required forms, with appropriate tracking in MatrixCare.</li><li>Notify the County Assistance Office (CAO) or applicable agency of income, asset, or status changes impacting eligibility.</li><li>Monitor pending Medicaid applications and communicate status updates to admissions, social services, and finance teams.</li><li>Prepare for and support Medicaid utilization reviews, eligibility audits, and third-party oversight (e.g., UMR), ensuring MatrixCare records and supporting documentation are complete and audit-ready.</li></ul>Private Pay &amp; Resident Financial Accounts<ul><li>Generate and distribute private pay statements from MatrixCare in accordance with established billing cycles and timelines.</li><li>Respond professionally and promptly to billing inquiries from residents and responsible parties.</li><li>Process refunds, adjustments, and rate changes accurately within MatrixCare.</li><li>Manage resident trust/personal allowance accounts when acting as representative payee, including required reporting for Social Security and Railroad Retirement benefits.</li></ul>Cash Posting, Reconciliation &amp; Reporting<ul><li>Post and reconcile cash receipts, electronic remittance advices (ERAs), and explanation of benefits (EOBs) to resident accounts in MatrixCare.</li><li>Reconcile payer remittances, billing logs, and CMS reports (including PS&amp;R) to ensure accuracy and identify discrepancies.</li><li>Prepare and submit required regulatory reports, including the Medicare Credit Balance Report.</li><li>Maintain accurate accounts receivable aging and supporting documentation using MatrixCare reporting tools.</li></ul>Collections &amp; Write-Offs<ul><li>Monitor outstanding balances using MatrixCare aging and AR reports and initiate follow-up actions in accordance with organizational collection policies.</li><li>Communicate unresolved balances, financial risks, and recommended actions to the CFO or Finance leadership.</li><li>Coordinate with CFO and legal counsel when necessary and maintain documentation for approved write-offs in accordance with internal controls and regulatory timelines.</li></ul>Accounts Payable &amp; Ancillary Coordination<ul><li>Review and approve resident-related ancillary invoices (pharmacy, therapy, labs, insurance premiums, physician services) for accounts payable processing when permitted.</li><li>Reconcile therapy and ancillary billing with departmental and MatrixCare records prior to approval.</li></ul>Compliance, Training &amp; Cross-Coverage<ul><li>Remain current on CMS guidance, Medicaid bulletins, managed care requirements, and MatrixCare system updates affecting billing and reimbursement.</li><li>Participate in ongoing education and training related to billing, compliance, reimbursement changes, and MatrixCare functionality.</li><li>Maintain strict confidentiality and comply with HIPAA and organizational privacy standards.</li><li>Cross-train and provide coverage for other billing functions as needed.</li></ul>Qualifications<ul><li>High school diploma or equivalent required; associate degree in business, accounting, or healthcare administration preferred.</li><li>Minimum five years of experience in healthcare billing, including Medicare, Medicaid, and managed care.</li><li>Experience with MatrixCare or comparable SNF EHR/billing systems strongly preferred.</li><li>Working knowledge of CMS billing rules, PDPM, managed care authorization processes, and coordination of benefits.</li><li>Strong analytical, organizational, and communication skills.</li><li>Ability to work independently, manage competing priorities, and meet regulatory deadlines.</li><li>Experience with Microsoft Office Suite.</li></ul>Pay: $25.00 per hourBenefits:<ul><li>Dental insurance</li><li>Employee assistance program</li><li>Flexible spending account</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Referral program</li><li>Vision insurance</li></ul>Work Location: In person

Nursing Care Billing Specialist

Salina Family Healthcare Center

<div>Please note that this is an in-person, non-remote position. 
Hiring Range - $18.50 - 21.15\hour 
FLSA Status: Non-Exempt 
Coder/Biller I General Description 

The Coder/Biller I provides coding and insurance support to the Billing Department and demonstrates understanding of health insurance, Medicare, Medicaid, FQHC nuances and the SFHC discount program to ensure the integrity of claims &amp; maximize reimbursement. May screen patients and assist the uninsured with enrolling in applicable discount/insurance programs. If applicable would need to meet requirements and competencies to be designated as a &ldquo;Certified Application Counselor or Navigator&rdquo; under CMS/HRSA definition. May be required to meet performance standards of Presumptive Eligibility Specialist to enroll qualified pregnant women and children in Kansas Medicaid. 
Mission &amp; Value Statements 
The mission of Salina Family Healthcare Center is to serve our community at the crossroads of compassionate healthcare and professional education. 
Salina Family Healthcare Center is guided by the following fundamental values:
<ul>
<li>Excellence;</li>
<li>Innovation;</li>
<li>Access;</li>
<li>Teamwork;</li>
<li>Equal dignity;</li>
<li>Education;</li>
<li>Ethics &amp; integrity;</li>
<li>Patient-centered.</li></ul> 


Coder/Biller I Essential Duties
<div>
<ul><li>Efficient timely review of patient charges prior to creating claims for accuracy and completeness; obtain/correct any missing information to reduce claim denial prior to creating claims; including orchard and non-billable holds as a priority.</li></ul>
<ul><li>Accurately review /code encounters for appropriate diagnosis (ICD10), procedures (CPT), HCPCS codes and modifiers prior to billing claims to maximize reimbursement.</li></ul>
<ul><li>Demonstrates and maintains working knowledge of third-party payer regulations and claim policies to include FQHC, Medicare and Medicaid, 340B, Lab NCD &amp; LCD as well as SFHC discount program to accurately submit claims.</li></ul>
<ul><li>Assist with reducing claim denials.</li></ul>
<ul><li>Monitor, identify, research and resolve outstanding unpaid claims.</li></ul>
<ul><li>Ensure the Discount Program integrity by updating claims as well as appropriate practice management systems accurately &amp; timely.</li></ul>
<ul><li>Meet requirements and competencies to be designated as a &ldquo;certified application counselor or Navigator&rdquo; under CMS/HRSA definition, if applicable.</li></ul>
<ul><li>Obtain Presumptive Eligibility Specialist designation and meet performance standards as outlined by KDHE-DHCF in order to enroll our pregnant women and children that are eligible in Kansas Medicaid if applicable.</li></ul>
<ul><li>Attend meetings as required.</li></ul>
<ul><li>Perform other duties as assigned.</li></ul></div> 


Coder/Biller I Skills Required 
 
<div><ul><li>Ability to establish and maintain effective working relationships with staff, patients and the public. 
</li></ul>
<ul><li>Knowledge of HIPAA privacy rules and regulations.</li></ul>
<ul><li>Excellent interpersonal, mathematical, verbal and written communication skills.</li></ul>
<ul><li>Ability to efficiently complete work is reasonably void of errors, and high in accuracy.</li></ul>
<ul><li>Excellent customer service skills and ability to effectively and respectfully interact with unsatisfied patients and coworkers.</li></ul>
<ul><li>Ability to manage multiple tasks, work under pressure, and prioritize workload, while maintaining efficiency and accuracy.</li></ul>
<ul><li>Effective and efficient time management and organizational skills. 
</li></ul>
<ul><li>Ability to follow written policies and procedures.</li></ul>
<ul><li>Ability to work independently and use good judgment.</li></ul></div> 


Coder/Biller I Education and Experience 
<div>
<ul><li>High school diploma required;</li></ul>
<ul><li>Certified Professional Coder (CPC) OR equivalent of two years coding and insurance in a medical related field;</li></ul>
<ul><li>Excellent organization, prioritization, and follow-up skills required; 
</li></ul>
<ul><li>Requires knowledge of ICD10, CPT and HCPCS Coding;</li></ul>
<ul><li>Social and cultural sensitivity appropriate to ethnically and economically diverse patient and employee-base.</li></ul></div> 


To see the full job description, please email careers@salinahealth.org with your requests.</div>

Coder/Biller I (In-Person Only Position)

Catholic Community Services and Catholic Housing Services of Western Washington

<div>Overview:
<div>
CLINICAL ACCESS SPECIALIST OPPORTUNITY</div><div>
TUKWILA, WA</div><div></div><div> 
CCSWW FAMILY BEHAVIORAL HEALTH TEAM AWARDED BY WSU &quot;EMPLOYER OF THE YEAR&quot;</div><div> 
OUR CLINICAL TEAMS WORK IN THE HOMES OF FAMILIES AND IN THE COMMUNITY; PLUS, IN AN OFFICE SITE</div><div></div><div> 
Catholic Community Services, Family Behavioral Health is looking for a Clinical Access Specialist Clinician who wants to join our team of innovators who continually &quot;push the envelope&quot; and challenges traditional thinking in Behavioral Health.</div><div></div><div> 
WHO ARE WE:</div><div>
We are a values-driven organization, providing family oriented mental health care for children, youth and families in their own home and community. Our enthusiastic clinical teams provide whatever is needed to help children and youth remain safely in their own home with their family, restoring hope, providing intense mental health services and supports, and helping to strengthen the family unity. With sites located in Tukwila, Tacoma, Olympia, Shelton, Bremerton, Aberdeen, Yelm, Vancouver, and Portland Oregon, we offer comprehensive intensive, Wrap-around mental health services to a diverse population for youth and families. We employ nearly 800 caring and compassionate employees.</div><div></div> 
WHAT WE VALUE: 
Compassion Diversity Strength-Based-Approach Social-Justice &amp; Our Staff!<div>
WHAT WE OFFER:</div><ul><li>
Starting Pay Range: $35.58 - 39.35 per hour</li><li>
Collaborative Supervision</li></ul><div>
 BENEFITS:
</div><ul><li>12 paid holidays; plus 1 personal holiday each year</li><li>
3 weeks' vacation (to start)
</li><li>12 sick-days per year</li><li>
Medical</li><li>
Dental</li><li>
Vision Insurance</li><li>
Life Insurance (1 times annual salary)</li><li>
Retirement Plans: 403-B Employee Savings Plan and an Employer Contribution Pension
</li></ul>Training and Supervision:<ul><li>
Extensive training in multiple clinical approaches as well as trainings in related areas
</li><li>Weekly supervision with your Clinical Supervisor
</li><li>Daily supervision and support, as needed</li><li>
Immediate assistance and clinical supervision/consultation available at any time</li></ul><div>
We strive to help children and families live together safely and securely with hope and promise. We serve as a catalyst for change when appropriate, challenging long-standing service traditions in community behavioral health. We behave with Humility, Passion for our Mission, and Compassion and Respectful Interactions. We value learning and offer alternatives and we stand strong to help child-serving systems understand our alternative paradigm while strengthening partnerships. We do not compromise our values.</div><div></div><div> 
This position is the first clinical contact for children, youth and families seeking referral and access to intensive level behavioral health services. The Clinical Access Specialist is responsible for determining eligibility and facilitating access to behavioral health services by using clinical and diagnostic assessment tools to gather child and family medical and behavioral health information, complete initial clinical assessment tool i.e. Child Adolescent Needs and Strengths and verify and determine eligibility for intensive behavioral health treatment services. The Clinical Access Specialist will continue to engage with the family, providing support and referrals as needed throughout the clinical assignment process. The Clinical Access Specialist will track all referrals, utilization and response timeframes and enter data into an Electronic Health record as appropriate.</div><div> 
</div><div>This position will be based out of FBH Tukwila, WA office. This position requires scheduling flexibility to meet the needs of youth and families served. The services we offer will be provided in community-based settings and in family homes. Work is performed under the supervision of the Clinical Supervisor or Clinical Manager.
</div>Responsibilities:
<div>
Clinical</div><ul><li>
Utilize Clinical assessment and engagement skills to meet with child, youth and family in the home, hospital or other community settings to gather demographic, clinical/situation information and assess for service need and intensity.</li><li>
Complete behavioral health clinical assessment tools including the CANS Assessment.</li><li>
Demonstrate familiarity with DSM criteria for clinical mental health diagnoses and formulate a clinical diagnosis based on client background and presenting behavioral health issues and concerns.</li><li>
Engage the child and family during the referral session, assessing for immediate safety needs and concerns and ensuring clinical support for the safety of the child throughout the referral determination process.</li><li>
Gather information from medical, behavioral health and other community providers for children/youth referred to support assessment for and access to services.</li><li>
Using an Electronic Health Record, Provider One, verify Medicaid eligibility for services.</li><li>
For referrals meeting access to care criteria, assess acuity level for response and coordinate referral assignment with identified clinical manager/supervisor.</li><li>
Communicate referral dispositions to Medicaid and BHO funders and obtain pre-authorization for those meeting service criteria. For those referrals not meeting criteria, report disposition information to funder in monthly reports.</li><li>
For referrals not meeting criteria for services, assist referent in resolving presenting concern, e.g. makes referrals to community resources, utilizing motivational interviewing and solution focused principles to resolve issue(s).</li></ul><div>
Manage access to services</div><ul><li>
Support and facilitate referral access in the community: represent Family Behavioral Health Services in the community by community outreach and collaboration. Develop and maintain strong and active relationships with funders, Behavioral health and Medical providers, Children&rsquo;s Administration, Juvenile Justice, community organizations, and other referral sources.</li><li>
Maintain on-going clinical contact with children/youth meeting access criteria for services pending clinical assignment, ensure appropriate and timely coordination, collaboration and support for behavioral health supports.</li><li>
Maintain contact with referents (community medical and behavioral health professionals) so that if youth is not immediately assigned, they are informed of the clinical intake process and authorization and approval for services. .</li><li>
Demonstrate flexibility and organization to respond to urgent referral requests in the home and community as needed, including flexibility to meet family and community needs after 5pm and on weekends.
</li><li>Maintain knowledge of community behavioral health and other support services to ensure all referents are linked to helping resources in their local communities from service referral to eligibility determination and disposition.</li><li>
Complete clinical assessment/referral documentation as required by funders and Medicaid, tracking client enrollment and referral documentation in clinical dashboard as needed for system wide behavioral health outcome reports.</li></ul><div>
Utilization tracking</div><ul><li>
Track and record Verification of Medicaid eligibility for all children/youth referred.</li><li>
Maintain tracking list of process steps for completion of required referral and intake activities, such as clinical assessment completion, referral dispositions, schedule and completed behavioral health intakes, initial treatment planning sessions with families, Medicaid authorizations and re-authorizations.</li></ul><div>
Quality Improvement</div><ul><li>
Participate in audit preparation and review of clinical records to ensure content, format, timeliness and quality standards of referral and initial documentation are Medicaid compliant for all children and youth.
</li></ul><div>HIPAA:</div><ul><li>
Responsible for upholding a culture of privacy and security in highly confidential work environment(HIPAA covered entity service area).</li><li>
Complies with all CCSWW policies and procedures that involve access to and safe guarding of client Protected Health Information (all forms).</li></ul>
Qualifications:
<div>
WHAT WE ARE SEEKING IN A CANDIDATE:</div><ul><li>
Bachelor&rsquo;s degree in social work, psychology, behavioral sciences or equivalent field.</li><li>
2 or more years of clinical experience working with children and families including knowledge of behavioral health and child welfare service systems.</li><li>
Clinical knowledge of DSM diagnostic and clinical criteria.
</li><li>Demonstrated clinical engagement skills which may include Motivational Interviewing or Collaborative Problem Solving.</li><li>
Eligibility for Agency Affiliated License and application within one month of employment</li><li>
Computer proficiency in Excel and Word and knowledge of Behavioral Health (EHR) electronic health record systems.</li><li>
Certification and competency in clinical assessment process including eligibility for certification in the CANS-Child/Adolescent Needs/Strengths Assessment, CALOCUS and knowledge in functional family clinical assessments.</li><li>
Energetic, innovative style with the ability to engage children, youth and family members in services.</li><li>
Enthusiastic and optimistic approach, encouraging ongoing participation of all involved.</li><li>
Natural ability to work with others through a genuine strengths-based approach, appreciating unique qualities and assets of all involved.</li><li>
Ability to work both independently and as a member of a team.</li><li>
Ability to meet with clients and colleagues in homes and community locations.</li><li>
Demonstrated strength in community capacity building and collaboration.</li><li>
Ability to prioritize and effectively handle competing demands.</li><li><div>
Applicant must successfully pass required background clearances prior to an offer of employment.</div></li><li>
Valid driver&rsquo;s license &amp; current automobile insurance, reliable transportation with an acceptable driving record per CCS policy.</li><li>
Support and uphold the mission, beliefs and values of Catholic Community Services and Catholic Housing Services.</li></ul><div>
Preferred Qualifications</div><ul><li>
Ability to engage children and families in crisis and in a variety of settings and circumstances.</li><li>
Excellent oral and written communication skills.</li><li>
Highly organized and a self-starter.</li><li>
Demonstrated ability to work in the context of a team.</li><li>
Computer proficiency in Psych Consult.</li><li>
Training and experience in CANS Assessment.</li></ul><div>
Internal applicants, please visit the HR Portal to apply with your updated resume, letter of interest, and to answr a few questions. For additional questions, contact Karla Lacktorin, Regional Healthcare Recruiter, at karlal@ccsww.org .</div>
Catholic Community Services and Catholic Housing Services is an Equal Opportunity Employer. Please let us know if you need special accommodations to apply or interview for this position.</div>

FBH Clinical Access Specialist

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