UW CODE AND REPRESENTATIVE GROUP

8075 (SEIU Local 925 Clerical Nonsupervisory)

BASIC FUNCTION

Coordinate a specialty Medical Assistance/Medicaid function; screen for and advise patients regarding Medical Assistance/Medicaid programs; complete Medicaid applications for patients; submit and monitor processing of applications.

Under general direction, coordinate all aspects of a specialty Medical Assistance/Medicaid function such as a facility placement, rehabilitation medicine transfers, or involuntary treatment procedure.

Assist patients and/or patient's families in completion of complex Medical Assistance/Medicaid applications; assess medical financial assistance eligibility; submit applications to Department of Social and Health Services (DSHS) office(s);

Screen unsponsored or limited-sponsored patients for Medical Assistance/Medicaid eligibility by reviewing patient's financial status;

Review reported income and assets for Medial Assistance/Medicaid eligibility; advise patients of Medicaid and uncompensated care programs;

Document progress of each case;

Advise patients and family members in accessing hospital and community services by consulting and making referrals to social workers, patient care coordinators, nursing liaisons, outside agencies and legal services;

Facilitate Medicaid eligibility process and timely movement of patient through hospital system to discharge;

Prioritize application requirements to ensure eligibility is approved upon transfer or discharge;

Compose correspondence requesting information, verifications and documentation to support the application and for DSHS eligibility determination;

Obtain required verification from patient or family members and medical reports from physicians; communicate status of application to hospital staff;

Ensure high priority is taken by all agencies to complete application process;

Manage case assignments by monitoring each phase of the application process;

Advise hospital staff regarding policies and eligibility criteria of medical assistance programs for discharge planning;

Advise and assist patients in the Medical Assistance/Medicaid reconsideration and fair hearing procedures;

Maintain and update Medical Assistance/Medicaid application tracking system;

Verify continued in-state or out-of-state Medical Assistance/Medicaid eligibility;

Maintain contact with patients to assist in response to additional requests from DSHS;

Complete presumptive applications for patients expired in the hospital without available next of kin;

Conduct home and jail visits to complete the Medical Assistance/Medicaid application process;

Request hospital, physician, and other provider bills to meet Medical Assistance/Medicaid deductible and spend down requirements;

Assist in training new employees and students;

Perform related duties as required.

Two years of experience as a Financial Services Specialist I

Equivalent education/experience.

New Class: 12-7-90