Revenue Maximization Specialist I

POSITION SUMMARY:

This position is responsible for learning and performing entry level eligibility tasks under supervision. The role performs Medicaid applications, placement report monitoring, and assistance with Relative & Non-Relative caregiver packets to support the Rev Max Department. This position works closely with other Rev Max staff, case managers, DCF staff, contract service providers, and coalition staff and ensures compliance with organizational policies, procedures, and applicable regulations. This position does not have supervisory responsibility.

KEY RESPONSIBILITIES:

• Core Responsibilities (to be learned and mastered):
• Process Medicaid applications for children in the care of the Community Based Care project under supervision.
• Monitor daily placement reports to identify new cases requiring eligibility/TANF actions.
• Assist with gathering information from appropriate resources (DCF, contracted agency and computer searches) to support Title IV-E eligibility determinations.
• Learn to accurately enter IV-E eligibility into required data systems within 24 hours of initial placement or placement change.
• Assist with processing Simplified Relative Caregiver Packets/Relative Caregiver Packets and Non-Relative Caregiver Packets, including gathering information and following up with case managers for missing documentation.
• Respond to basic inquiries from Coalition staff regarding Medicaid benefits and eligibility-related questions, escalating complex questions to Level II Specialists or Supervisor as needed.
• Assist with setting up and maintaining Revenue Maximization case records which meet all Community Based Care, state and federal requirements.
• Assist with uploading documentation into FSFN/CCWIS on behalf of the Rev Max team.
• Assist Level II Specialists and Supervisor as needed.
• Completes other tasks as needed or assigned.

Additional Responsibilities (to be cross trained over time):

• Learn to process initial TANF applications and yearly renewals for children placed in non-licensed out of home care and in home living arrangements.
• Learn to process annual redeterminations of IV-E and/or Medicaid.
• Learn to prepare the revenue maximization case record for audits and monitoring according to Community Based Care, federal and state regulations.
• Learn to process Title IV-E eligibility determinations under the guidance of Level II Specialists or Lead Specialist.
• Assist with notifying Community Based Care accounting department regarding SSI/SSA income changes as applicable.

A comprehensive benefits program including:

5 weeks of PTO accruals available during the first year of employment

12 paid holidays

Professional development

Ongoing coaching and feedback

Employee Assistance Program (“EAP”)

Health Benefits with shared premium costs, including:

Medical

Dental

Vision

Life

Short-term disability

Long-term disability

401(k) retirement

EDUCATION/EXPERIENCE:

Bachelor’s degree in social services or related field preferred or Five years of experience working in related areas such as child protection or case management. Experience using FSFN/CCWIS or Florida system (ACCESS/Medicaid). 

LIST OTHER MINIMUM REQUIREMENTS:

• Must meet state criminal background check requirements. 
• Ability to work a flexible schedule.
• Knowledge of community resources. 
• Must possess and maintain a valid Florida driver’s license in good standing and comply with all agency driver guidelines and insurance requirements.