Medicaid Pending Specialist - Cliveden Nursing and Rehabilitation Center

Cliveden Nursing and Rehabilitation Center is part of the Bedrock Care each facility offers skilled nursing short-term rehabilitation and long-term care services. Our staffs are committed to providing excellent care and services in a friendly, resident-focused, home-like environment.

The MA Specialist works closely with the Admissions Director and Business Office Manager to determine what residents will need for a Medicaid application as well as follow through with the application process through to approval/denial.

Essential duties and responsibilities include but are not limited to:

• Create an MA Pending case file; enter new residents into the MA Pending Tracking Log and fax MNHCLR to Philadelphia County Assistance Office.
• Work with the RNAC (Registered Nurse Assessment Coordinators) to have the MA 51 before the scheduled assessment; schedule PCA assessments and coordinate with families if they will be attending. Following up with PCA to receive the Options Determination Report.
• Complete PA 600 with Resident and /or Responsible Party.
• Contact Philadelphia County Assistance Office for the caseworker assigned, and work with the caseworker and family to provide necessary documentation until the case is approved. Contact banks, insurance companies, and pension companies requesting verification needed to determine the consumer's MA eligibility.
• Meet all deadlines associated with each MA pending case to ensure that the appropriate MA effective date is obtained.
• Upon receipt of PA 162, review for accuracy, effective date, income, deductions, etc. Scan to the billing office, PA Regional BOM, RNAC’s BOM, and Administrator. File one in PA 162 book and one in the resident’s file. Complete Medicaid Redeterminations timely and return County Assistance Office to prevent cases from being closed.
• Attend meetings that include the MA Pending process.
• All other responsibilities deemed appropriate by the Regional PA Business Office and the Director of AR.

Applicant requirements include:

• CDC COVID-19 vaccination card showing fully vaccinated
• Proficiency using Health Information Management systems as well as Microsoft Office applications
• One-year experience as a Medicaid Pending in a long-term care facility
• The company offers a generous annual salary and signing bonus as well as:
• Health, dental and vision benefits
• Voluntary benefits such as short-term disability, life insurance, etc.
• Holiday, sick, and vacation paid time off.
• 401(k)

We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.