United States onlyThe Case Reviewer supports the processing of Financial Eligibility determinations and Redeterminations for those seeking New Hampshire Medicaid Long-Term Care assistance. In this role, incumbents process financial eligibility applications effectively and efficiently to facilitate timely determinations and redeterminations, and ultimately, access to long-term care to improve the well-being of those seeking LTC services.
Requirements
- Manage assigned caseload and complete all eligibility determination tasks within State-specified timelines
- Maintain accurate and timely documentation of applicant information using State case management and eligibility systems
- Review assigned cases for completion and identify whether additional documentation or information is needed to make eligibility determinations or redeterminations
- Schedule and conduct virtual interviews with applicants to review and confirm application documentation and information
- Provide education to applicants and their representatives around financial eligibility criteria and any additional documentation required
- Use provided checklists, tools, and decision trees to verify whether documentation demonstrates applicants meet State and Federal financial eligibility criteria
- Utilize State case management systems, checklists, and verification tools to develop and submit eligibility recommendations in accordance with State policy and federal Medicaid rules
- Receive and process calls and electronic inquiries (email, phone, fax) related to application status, documentation questions, timelines, and next steps
- Support supervisor with correcting errors identified during quality assurance audits
Benefits
- Health, vision, and dental insurance
- 401(k) with discretionary employer match
- Paid time off and holidays
- Flexible spending accounts
