San Fernando, Pampanga, Philippines
Medicaid Financial Analyst
Job Description:
Remote Employee BPO has an outstanding opportunity for you!
Role: Medicaid Financial Analyst
Compensation: Competitive Basic Salary
Bonus: 5,000 Perfect Attendance
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:
- Accounting or accountancy degree (CPA not required) or potentially a paralegal with strong numbers skills.
- Demonstrated ability to analyze complex financial data and provide actionable insights.
- Strong focus on accuracy and detail in data analysis and reporting.
- Ability to understand and optimize workflows within the Medicaid pending process.
- Effective verbal and written communication skills to present findings and collaborate with team members.