Benefits Eligibility Specialist

Helena, MT

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Description

Look no further for an amazing opportunity!!  Now Hiring a Benefits Eligibility Specialist for a non-profit health organization in Helena, MT!!

Term: temporary, 1-3 months

Schedule: Full Time M-F, 8-5

Pay: $24.50

Duties:

  • Performs Level of Care telephone review for Medicaid recipients to ensure proper utilization of services (i.e. nursing homes and Home and Community Based Services), using the Department’s criteria
  • Performs PASARR telephone review and referrals for Level II as necessary, adhering to the Federal regulations. PASRR refers to Pre-Admission Screening/Annual Resident Review and is performed on all individuals entering the long term care environment. Level II referrals are made to a mental illness or developmental delayed specialist
  • Enters determination results into the database for all types of review
  • Communicates via phone or fax the determination results to the appropriate entities. 5. Attends team meetings as scheduled

Qualifications:

  • Licensed Practical or Registered Nurse with current Montana license or Bachelor’s Degree in social work
  • Work experience in a clinical, hospital, nursing home or home health environment
  • Knowledge of criteria and federal guidelines related to all review types
  • Good analytical skills
  • High degree of customer service skills required to successfully interact with consumers, referral sources, and State and agency personnel
  • Knowledge and understanding of Montana home care services and issues as they relate to Medicaid Personal Assistance Services and HCBS
  • Intermediate computer skills

 

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