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.