The Denver Hospice · 8 hours ago
Eligibility & Financial Determination Specialist - PACE
Aurora, Colorado, United States
Full-time
Onsite
Entry, Mid Level
$19.29/hr - $22.50/hr
2+ years expThe Denver Hospice is seeking an Eligibility & Financial Determination Specialist for their Colorado PACE program. This role involves reviewing and preparing Medicaid applications, ensuring compliance with regulations, and providing support to the Enrollment Team and interdisciplinary teams regarding eligibility and financial classification issues.
Health CareHospitalNon Profit
Responsibilities
Reviews/prepares Medicaid applications and partners with the Enrollment Team and PACE Interdisciplinary Team (IDT) to obtain all required financial and personal documentation needed for timely eligibility decisions
Serves as the primary point of contact regarding Medicaid application processes, best practices, and ongoing training
Maintains a tracking system for all submitted applications from initial submission through approval, providing regular updates to the Director of Business Development, PACE Center Director(s) and PACE Executive Director
Ensures all applications comply with Colorado Medicaid rules and regulations, including updates to Health First Colorado, Long-Term Care (LTC) Medicaid, Spousal Impoverishment provisions, Trusts, Old Age Pension (OAP), and related Medicaid programs applicable to PACE participants
Collaborates with Accounts Receivable to monitor and resolve monthly Medicaid-related issues for PACE participants
Monitors private pay participants and supports seamless transitions to Medicaid eligibility when appropriate
Ensures all eligibility staff maintain current knowledge of Medicaid policies and application processes
Responds promptly to adverse action notices, including 10-day notices, denials, and requests for additional information from County Human Services
Troubleshoots complex eligibility cases in partnership with Enrollment Team and IDT
Provides regular updates to Director of Business Development, PACE Center Director(s) and PACE Executive Director on application status, assisting with questions, barriers, and required follow-up
Collaborates with County Human Services, Social Workers, Intake, and PACE interdisciplinary teams to resolve eligibility, financial classification, and documentation issues
Demonstrates leadership by modeling professionalism, providing guidance, and supporting positive morale and teamwork within the Enrollment team
Qualification
Required
High School Diploma or equivalent
Prior experience working with the frail and elderly population in a healthcare setting
2 years' experience in Medicaid eligibility, financial determination, or benefits coordination
1 year experience working with CMS and strong knowledge of Colorado Medicaid Benefits
Valid Colorado Driver's License and proof of auto insurance
Ability to lift/carry a minimum of 30 lbs
Benefits
Low healthcare premiums: we have not increased our team member medical rates 4 out of the last 5 years
Employer pays over 90% of employee medical premium in some plans
Health Savings Account (HSA) with significant Employer Funding: Single $1,000, Family $2,000
Healthcare Benefits are effective on the 1st of the month following date of hire
Extensive Paid Time Off (PTO/Vacation Pay/Sick Leave) and EIB (Extended Illness Bank): 18 days in the first year for FT team members
Seven Paid Holidays with an additional Floating Holiday
403(b) Retirement Plan with Employer Match: 50% match up to 8% of total compensation
Company-Paid Life and AD&D Insurance
Career & Logo wear
Education Reimbursement Program
Clinical Career Ladders
Certification Pay
Generous Discover-a-Star Team Member Referral Program
Team Member Service Awards
Early Wage Access
Legal and Identity Protection
Robust Leadership Development Training Programs
Company
The Denver Hospice
The Denver Hospice is the region’s leading, largest and most trusted not-for-profit provider of life-enhancing hospice and palliative care.
201-500 employees
Funding
Current Stage
Growth StageRecent News
Morningstar, Inc.
2024-12-21
Company data provided by crunchbase