Medicaid Waiver Specialist Golden Gate Regional Center 11 reviews - San Francisco, CA $38,000 - $40,000 a year Performs administrative functions related to designation of individuals supported by the agency to be eligible for federal Medicaid Waiver benefits and ensures that documentation meets State and Federal requirements. This position also provides relief coverage for GGRC front desk reception as needed. DUTIES Medicaid Waiver Transactions - Inputs information on eligible individuals for Medicaid Waiver transactions; cross checks entries at the end of each month. Scans and indexes Medicaid Waiver related documents to electronic records system. Assures timely completion and filing of Consumer Choice of Services/Living Statement. Reviews case files and makes recommendations concerning eligibility and updates Eligibility list as needed. Prepares Institutional Deeming Referrals and communicates with Case Managers, Medi-Cal Specialists and Department of Developmental Services (DDS); Verifies for active Medi-Cal numbers on a monthly basis and prepares and processes required paperwork for eligible individuals. Notifies Case Managers of terminations and distributes correspondence, including NOA (Notice of Action)/certified mail at the direction of Supervisor. Informs and provides input to case managers regarding documentation and status of Medicaid Waiver participants. Monthly Recertification Review: At the beginning of each month, obtains, reviews, and consolidates GGRC and State Recertification lists; prints, stamps, and sorts individual eligibility records. Verifies needed documentation in records and follows up with case manager as needed. Tracks completed Recertifications throughout the month and reviews case files for Annual Recertification to ensure the participant continues to meet the Medicaid Waiver Program requirements; ensures case records are properly prepared and stored on file. Makes recommendations related to corrective actions to address deficiencies and/or inconsistencies. Retrieves and distributes mail for Medicaid Waiver Team and adheres to current DDS requirements for administering the Medicaid Waiver Program. Prepares specialized correspondence for GGRC participants and their families as well as prepares supporting data and documents for meetings and trainings as needed. This position provides relief coverage for front desk reception which on occasion will require working until 5:00 pm. Maintains all client information as confidential in compliance with the Federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the California Lanterman Act. Participates in special projects, and assist with additional duties or tasks, as assigned. EDUCATION AND EXPERIENCE * College Graduate with majors or minors in Health Sciences, Social Work or related fields of studies. * 1 year minimum administrative experience in a professional setting performing a variety of administrative functions. * Experience in reviewing of medical records. * Must meet the standards for being QMRP Qualified. * Experience in multi-cultural settings and/or multi-lingual capacity. SKILLS AND COMPETENCIES * Experience in extracting and combining data and spreadsheets into usable reports * Ability to convey complex information and ideas orally and in writing in a clear, concise and professional manner * Advanced proficiency MS Word®, MS Excel®, MS Outlook® or similar software applications * Previous experience in use of electronic records system * Strong organizational skills * Time management * Attention to detail and analytical skills * Collaboration/teamwork * Ability to multi-task with competing priorities