Administrative - Medicaid Specialist

Administrative - Medicaid Specialist

Medicaid/Continuous Quality Improvement (CQI) Specialist

Sequel Youth and Family Services of Tuskegee, a residential treatment program for male adolescents with severe emotional and behavioral disorders, has an immediate opening for a full-time Medicaid/CQI Clerk.

 

The Medicaid/CQI Clerk ensures that all resident records meet standards of internal policies and procedures, AL Department of Human Resources/AL Department of Youth Services as to format and timeliness.  Collects, inputs, and files information to ensure accurate and timely completion of the Medicaid billing process. Serves on Safety and Clinical Medical committees and assists with the development, implementation, and compliance of all safety programs and policies within the facility.  

 

Duties Include:

·        Monitors resident charts and oversees the proper filing of resident records.

·        Responsible for the storage and protection of resident records.

·        Communicates findings of resident record audits via memo and committee meetings.

·        Reviews deficiencies noted on chart audits to ensure corrections have been made.

·        Assists with Admissions/Intake. Tracks referrals and census data.

·        Collects supporting documentation from all departments indicating delivery of billable services to participating clientele in the AL Medicaid Program.

·        Ensures accurate and timely input of information into the program's Medicaid Billing Program.

·        Ensures billing information is forwarded to the Accounts Receivable department on a monthly basis.

·        Maintains Medicaid documentation in accordance with program operating procedures and policies as well as auditing entities for Medicaid.

·        Monitors the billing process to determine efficiency and effectiveness in maximizing billing potential.

·        Coordinate with directors to track Risk Management: collect, review, and correlate data of all risk incident reports.

·        Coordinate with directors to track Risk Management by assisting to maintain documentation of all Incident Reports.

·        Generates monthly, quarterly, and annual Risk Management Reports and reports findings to the appropriate Committee. 

·        Coordinate with directors to track Risk Management by assisting with documentation of the Performance Improvement and Outcomes Management activities for the facility.

 Qualifications:

·        High School Diploma or equivalent.

·        Familiarity with record keeping system in a psychiatric or residential setting with direct involvement with records in such a facility.

·        Previous experience with children/adolescents ages 12-18 in the Mental Health field is preferred.

·        Quality assurance/improvement process experience is preferred. 

·        Must have exceptional verbal and written skills.

·        Must possess initiative and judgment capabilities to organize and plan activities, systematize procedures, collect data, compile statistics, track and trend identified problem areas, and compile meaningful reports.

·        Must be flexible to adjust to changing conditions and varied duties of the position.

·        Ability to recognize and maintain confidentiality of resident records and information.

·        Ability to interpret and comply with standards of AL Department of Human Resources/Al Dept. of Youth Services.

·        Strong computer literacy including the ability to use various hardware and software (word processing, etc.).

 

Benefits:

·        Medical, Dental, Vision, and Life Insurance after 30 days

·        Company provided Short Term and Long Term Disability

·        Company provided AD&D insurance

·        Flexible Spending program

·        401K after sixty days

·        6 paid holidays

·        18 days personal leave accrual within first year