Deonie Gray

Intake Medicaid Processor 9/2024 – Current

Completing and managing Medicaid recertifications for the Palm Beach PACE Program.

Completes all paperwork and documentation needed to submit to DCF.

Maintains open communication with DCF to ensure the completion of Medicaid recertifications.

Collect documentation and submit the Medicaid (HCBS) application on the MYACCESS website.

Ensure a proper Medicaid application process with the Department of Children and Families, including secure document management (PHI).

Check FLMMIS and CMS websites daily, weekly, and monthly for reports to maintain active Medicaid and Medicare status for PACE client census. Once the report is obtained, review and process the case accordingly.

Responsible for ensuring compliance with program requirements, regulations, and complying with all security and confidentiality regulations for Medicaid Long Term Care, verify customer demographic and case status information in FLMMIS.

Complete and submit the change (2506 & 2515 Form) to DCF for processing.

Communicate with the client, POA, and social worker to coordinate benefits.

• Processed verification requests from State Medicaid Agencies and coordinated with members and third parties remotely.
• Conducted telephonic outreach for potential members eligible for State Medicare Savings and Medicaid Programs.
• Managed communication with State Medicaid staff, prioritized tasks based on deadlines, and ensured compliance with HIPAA and regulatory requirements.
• Facilitated submission of application packages, reviewed member inquiries, and provided comprehensive support for application processes.
• Handled State Notices, obtained Medicaid application outcomes, and maintained current knowledge of Medicaid eligibility requirements.
• Managed incoming correspondence, ensured application completeness, and supported management with additional assignments.
• Conducted telephonic screenings to determine member eligibility for Medicare Savings, State Medicaid, Extra Help, and community programs.
• Achieved monthly production goals, maintained high-quality scores, and ensured compliance with Medicare, Medicaid, and HIPAA regulations.

• Investigated errors and rejected transactions from CMS on daily, weekly, biweekly, and monthly Transaction Reconciliation Reports (TRR).
• Conducted root cause analysis of errors and rejections, identified trends, and reported findings to management.
• Collaborated with program coordinators and IT team to propose, develop, and test system enhancements.
• Reviewed and reconciled Enrollment, Disenrollment, and maintenance count reports with CMS, addressing root causes of discrepancies.