Long Term Care Specialist

Elevate Patient Financial Solutions has an exciting career opportunity available as a Long-Term Care Specialist.

This position will be remote based.

The Full Time schedule for this role will be 8:00AM-4:30PM, Monday-Friday.

Job Summary

The Long-Term Care Specialist is that member of the Operations Team who appropriately interacts/ interviews referrals from the facility in a professional and business-like manner. Functions as the interface between Elevate Clients and the State, Federal, County, Medical or Disability agencies to which we are applying. This position may assist in the training of Eligibility staff performing patient-oriented tasks and follow up; as well as in the monitoring of work guidance and performance measures to meet goals for delivery of service.

Essential Duties and Responsibilities

This position performs detailed in-house review and bedside interviews to determine if patient is a viable candidate for Long-Term Care or other Medical Assistance programs through State, Federal, County, Medical or Disability Assistance, and if so to assist the patient/guarantor with the application process for any Assistance type program. This assistance will include the necessary investigative, field, Medical review and administrative work needed to assist the patient in meeting eligibility requirements for Disability, Medicaid or other applicable County, Federal or State programs if appropriate.

• Assists in mentoring and providing guidance to staff on proper procedures and development of core skill sets in accordance with Elevate training manuals, policies, and established guidelines.
• Provides assistance to the leadership in evaluating and assessing employee progress.
• Able to interact with senior management, and client on a basic and administrative level with professionally courtesy and advanced customer service skills.
• Interact with patients, patient representatives and/or families in order to obtain or determine the eligibility of the patient for Federal or State assistance for Long Term Care or other Medicaid programs.
• Explain to patients and other entities the eligibility requirements, application process and verification requirements for applicable programs.
• Facilitate the application process when appropriate by assisting the patient in completing the application, scheduling appointment interviews and obtaining required verification.
• Document pertinent patient information and account activity in the appropriate systems dictated by the health care facility and ElevatePFS account, as required by Elevate policies and procedures in order to support account dispositions.
• Effectively request and track field visits, utilizing correct criteria in accordance with Elevate training manuals.
• Maintains advanced knowledge of peripheral systems; EVS, ACEDS.
• Determine potential eligibility for Long-Term health care coverage in accordance to state/federal/local policies and procedures.
• Submit accurate and concise information to facilitate appropriate billing follow up.
• Consistently updates knowledge of multi-state/federal/local program policies and procedures.
• Monitor patient accounts to ensure appropriate processing timeframes are met.
• Maintain confidentiality regarding patient's health records.
• Maintain confidentiality regarding Elevate business practices.
• Conduct business in an ethical manner that promotes the Mission, Vision, and Values of Elevate.
• Works with upline leadership on all other duties as assigned in order to insure the outcomes for Elevate as a single organizational entity.
• Regular and timely attendance.
• Other duties as assigned.

Qualifications and Requirements

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities.

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities.
• Some college and two years related experience and/or some combination of education, related experience and/or training.
• Advanced understanding of the Medical Assistance application process, including a basic understanding of various aspects of eligibility analysis and evaluation process.
• Knowledge of multiple state/federal/local program policies and procedures
• Ability to use a PC effectively including various database programs.
• Accurate typing/data entry at a minimum of 30 wpm.
• Proficient in Microsoft Office applications, including advanced Excel, charts, graphs, Power Point.
• Ability to communicate effectively in writing and verbally.
• Skill in reading documents written in Standard English text such as administrative policy and procedures manuals.
• Ability to establish and maintain cooperative working relationships with patients, third party resources, co-workers and management.
• Able to follow complex instructions and procedures, paying close attention to details and to organize work in a systematic and efficient fashion.
• Skilled in organizing and setting priorities, which accurately reflect the relative importance of job responsibilities.
• Skilled in speaking clearly and distinctly using appropriate vocabulary and grammar to obtain the information necessary to execute the business of Elevate.
• Ability to adapt to a flexible schedule.
• Availability of reliable transportation for use in Field Visits.
• Remote and Hybrid positions require home internet connections that meet the Company's upload and download speed criteria.

Benefits

ElevatePFS believes in making a positive impact not only within our industry but also with our employees -the organization's greatest asset! We take pride in offering comprehensive benefits in a vast array of plans that contribute to the present and future well-being of our employees and their families.

• Medical, Dental & Vision Insurance
• 401K (100% match for the first 3% & 50% match for the next 2%)
• 15 days of PTO
• 7 paid Holidays
• 2 Floating holidays
• 1 Elevate Day (floating holiday)
• Pet Insurance
• Employee referral bonus program
• Teamwork: We believe in teamwork and having fun together
• Career Growth: Gain great experience to promote to higher roles

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, location, specialty and training. This pay scale is not a promise of a particular wage.

The job description does not constitute an employment agreement between the employer and Employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

ElevatePFS is an Equal Opportunity Employer