Apply on Employer Site

AmeriHealth Caritas · 10 hours ago

Coordinator Disability Advocacy Program

United States

Full-time

Remote

Mid Level

3+ years exp

AmeriHealth Caritas is a mission-driven organization focused on healthcare solutions. The Coordinator for the Disability Advocacy Program is responsible for managing case files and coordinating the application process for members eligible for SSI or CSHCS benefits.

Health CareInformation Technology

Responsibilities

Responsible for the preparation of case management files for assigned Plan members who are eligible to receive Supplemental Security Income (SSI) or CSHCS benefits and the creation and maintenance of case management documentation in the CSHCS/SSI database

Coordinates with the Manager of the DAP and the UM associates to receive monthly data loads and distribute member data to UM for process of renewals

Coordinates and facilitates the CSHCS/SSI conversion application process by working closely with member, providers, Utilization Management (UM), and the local Medicaid office (MC), as needed

Coordinates with UM to contact members and/or process mailings to Plan members identified as eligible for renewal in the CSHCS/SSI program

Maintains relationship and works with providers to facilitate the exchange of medical documentation regarding specialty treatment received for designated chronic medical conditions

Work involves frequent contact with members, medical services, government services, providers and others to obtain and verify medical and financial information needed to determine SSI/CSHCS eligibility

Qualification

Managed care experienceMedical terminologyMedical records proceduresFacetsJivaEXPRightFaxMS OfficeReferral proceduresCSHCS programUtilize cultural resources

Required

High School Diploma/GED required

3 to 5 years managed care experience

Knowledge of medical terminology & medical records procedures

Knowledge of Facets, Jiva, EXP, RightFax, MS Office

Knowledge of referral procedures for case management, including state requirements regarding case management

Ability to identify and utilize cultural and community resources useful

Preferred

Associate's Degree preferred

Knowledge of Children's Special Health Care Services program and/or medical claims processing in a disability determination service office or related experience preferred