layiq

/la·yiq/adjective

worthy; deserving; fitting; suitable.

A role, opportunity, or path that merits attention, time, and pursuit.

Senior Patient Financial Services Specialist Per Diem at Hebrew SeniorLife | LAYIQ

MassHealth (Medicaid) Eligibility & Maintenance
Complete and submit MassHealth applications and renewals accurately and timely
Assist patients, families and guarantors in gathering required financial documentation
Resolve eligibility issues, denials, and coverage gaps
Stay current with Massachusetts Medicaid regulations and policy changes
Track and manage all resident MassHealth renewal dates on a rolling 12-month cycle
Initiate renewal process upon receipt of MassHealth notices; monitor deadlines and follow up on outstanding documentation
Financial Coordination
Verify insurance coverage and benefits across multiple payers in conjunction with admissions.
Collect, review, and organize required financial documents (bank statements, income verification, asset records, social security records, etc.)
Determine ability to pay privately vs. eligibility for assistance programs.
Coordinate transitions between payers (e.g., Medicare to Medicaid; Private to Medicaid)
Ensure accurate payer source assignment and billing readiness
Coordinate with billing as needed.
Patient & Family Support
Educate patients, families and guarantors on coverage options, financial responsibility, and eligibility requirements
Provide guidance on spend-down requirements, asset documentation, patient paid amounts and compliance
Serve as a point of contact for financial inquiries and concerns
Help residents and family understand how to pay for care
Make complex financial systems understandable
Maintain accurate and up-to-date resident financial files.
Compliance & Documentation
Maintain accurate, complete, and audit-ready financial records
Ensure compliance with Federal and Massachusetts Medicaid regulations
Support internal and external audits related to billing and eligibility
Identify and escalate potential eligibility issues for MassHealth (excess assets, missing documentation, etc.)
Accounts Receivable
Follow up on unpaid claims, resolve discrepancies, and ensure timely payments.
Monitor and track accounts receivable, ensuring all payments are received timely
Work with residents, families, and external agencies to resolve any billing issues or payment delays.
Systems & Reporting
Maintain tracking systems (spreadsheets or software) for MassHealth renewal timelines and outcomes
Support audits and internal reviews related to eligibilities and reimbursement
Generate reports on upcoming MassHealth renewals, MassHealth Pending and submission statuses, etc.
Collaboration
Communicate with state agencies, managed care organizations, and third-party payers
Communicate MassHealth renewal requirements, deadlines, and status updates clearly and professionally
Participate in interdisciplinary care and discharge planning as needed
Provide financial insight that impacts discharge planning or long-term placement.
Coordination with interdisciplinary teams (admissions, social workers, clinical, billing, etc.)
Core Competencies: Competencies
Analytical thinking and problem-solving
Regulatory and policy expertise
Compassionate patient interaction
Organizational and time management skills
Adaptability in a complex reimbursement environment
Problem solving and critical thinking
Time management skills

Senior Patient Financial Services Specialist Per Diem

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