Medicaid Financial Analyst

Remote Employee BPO has an outstanding opportunity for you!

Benefits: HMO plus 2 Free Dependents, P1,500 Rice Allowance, and Night Differential

Work Schedule: 5-day work week, 8:00 p.m. to 5:00 a.m. Philippine Time

Work Setup: WFO (Office-based)

Responsibilities:

• Keeps close communication with facility business offices and Medicaid Coordinator. Prioritize work according to facility needs and deadlines.
• Obtains 5 years of bank statements from banking institutions, using Authorization to Represent.
• Places bank statements into our banking software, which will automatically identify potential flags with the Medicaid application that will require further documentation.
• Based on potential flags identified by software, Medicaid analyst creates a folder on SharePoint site for each issue identified, where documentation will go once obtained.
• Potential flags identified that are appropriate for the Medicaid Analyst are consistently followed up on (such as retirement statements, life insurance, other bank accounts, etc.) to obtain documentation.
• Potential flags requiring conversation with patients or family members, are communicated to the Medicaid Coordinator who will work directly with patients or family at the nursing facility.
• As we receive letters from the county requesting information for items that our software did not catch, software logic must be updated by analyst.
• Information is kept confidential and Health Insurance Portability and Accountability Act ( HIPPA ) is followed.
• Obtains an understanding of Medicaid (will receive training).
• Medicaid eligibility guidelines when there is spouse in community
• Medicaid eligibility guidelines when there is no spouse in community
• Assets and income allowed.
• Calculation of sanction periods
• Calculates Net Available Monthly Income (NAMI), for each applicant, with documentation of calculation, and sends to Business Office and Medicaid Coordinator.

Qualifications:

• Highly Analytical: Demonstrated ability to analyze complex financial data and provide actionable insights.
• Attention to Detail: Strong focus on accuracy and detail in data analysis and reporting.
• Process-Oriented: Ability to understand and optimize workflows within the Medicaid pending process.
• Communication: Effective verbal and written communication skills to present findings and collaborate with team members.