Ability Unlimited Waiver Services Representative
Ability Unlimited Front Royal, VA
- Expired: 13 days ago. Applications are no longer accepted.
• Accurately identifies the services per manuals and guidelines, that best meet the individual's needs.
• Effectively answers client and prospect questions and promptly follows up with additional resources/information.
• Understands and respects the individual's rights to make decisions about, directing the provisions of, and control his/her services.
• Mentors new clients and caregivers through the request for authorization process and provides support when needed.
• Follows up with clients weekly on the status of their submitted requests.
• Provides examples and guidance to practitioners and therapists per criteria and guidelines per the medical necessity.
• Follows up with therapists and practitioners frequently per requested documentation, for a timely return.
• Follows up with MCOs/KePro/WaMS and other entities worked with on all SARs submitted and provides input as necessary, through completion of the review.
• Document, in detail, every phone call, email, and correspondence, inbound or outbound in the company system from the client, primary caregivers, care/support coordinators, therapists, and practitioners.
• Mentors families with navigating the appeals process and compiling needed follow-up documentation, if requested.
- Displays detailed knowledge of all Medicaid services (Assistive Technology (AT), Durable Medical Equipment (DME), and Environmental Modifications (EM)) and can identify what is available to each client served.
- Understands the rules and regulations, application process, eligibility criteria, appeal process, rights and procedures, transfer process, and services available under CCC Plus Waiver, DD Comprehensive waivers, Early, Periodic, Screening, Diagnosis, and Treatment (EPSDT), and other Medicaid programs as necessary.
- Understands the roles and responsibilities of all of the entities involved in administering Virginia Medicaid Waiver services.
- Understands and communicates the role of Prior Authorization of services.
- Excellent and building rapport, people-oriented, Strong written and verbal communication skills, Good organizational skills, Willing to learn regulations and manuals.
- Requires a documented combination of skills/relevant work and education experience.
- Have good interviewing techniques, be able to work independently, and communicate effectively both orally and in writing.
- High school graduate and some college experience (preferred).
- One year of Administrative experience required.
- Have appropriate home office equipment sufficient to perform job duties. i.e. a reliable internet connection; desktop computer with no less than i7 core processor and 500GB hard drive and 8GB RAM; one monitor, 2 monitors preferred; camera; headphones; printer; scanner and a dedicated workspace.
- Submit to a criminal background check(s) and drug testing.
- Two references are required.
AddressFront Royal, VA
EducationView all jobs at Ability Unlimited