ATHENA Consulting is an award-winning staffing firm serving state and local governments. Our mission is to make lives better! We make our Clients’ Lives Easier by engaging and supporting our clients and partnering with them to be the most knowledgeable staffing partner. We make our Employees’ Lives Better by identifying and cultivating their talents and matching these talents with our customers’ needs. ATHENA places a high value on customer service, accountability and getting the job done.
POSITION SUMMARY:
This FULL-TIME position pay range is $20.00-$23.00 per hour and is located in Olyphant, PA. The Disability Case Developer is responsible for developing medical files from start to finish for clients applying for Medicaid disability through the State of Colorado. This role involves obtaining and reviewing medical documentation, coordinating with healthcare providers and clients, maintaining case timelines, preparing correspondence, and ensuring accurate and timely case development in accordance with program requirements, and other duties as assigned.
This position is 100% on-site in Olyphant, PA. Remote work is not available.
Schedule: Monday through Friday, 8:30 AM – 4:30 PM
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:
- Build and maintain effective working relationships with clients, eligibility sites, medical providers, and internal stakeholders to facilitate the Medicaid Disability Determination process.
- Develop and maintain linkages with Eligibility Sites to support individuals applying for Medicaid disability benefits.
- Contact healthcare providers to obtain objective medical documentation required for disability determination reviews.
- Develop medical files from intake through final determination, ensuring complete and accurate case development.
- Conduct Medical Eligibility reviews and prepare cases for submission in accordance with State of Colorado requirements.
- Compose professional letters, correspondence, memos, and other case-related documentation using independent judgment regarding content.
- Compile, analyze, and organize information from multiple sources to support disability case development.
- Respond to inquiries and explain services, policies, procedures, and program requirements to clients, providers, and other stakeholders.
- Maintain thorough and accurate case records throughout all stages of the disability determination process.
- Track diary dates and ensure compliance with all case development timelines.
- Contact clients within 24 hours of assignment to confirm receipt of the case and request any additional required documentation.
- Send medical release forms and requests for objective medical documentation to treating providers within 48 hours of case assignment.
- Conduct follow-up with medical providers within five business days and document all activity.
- Schedule consultative examinations when sufficient objective medical documentation has not been obtained within established timeframes.
- Notify clients within 24 hours of consultative examination scheduling and obtain attendance confirmation.
- Perform follow-up with clients when appointment confirmation has not been received.
- Ensure sufficient objective medical documentation is obtained within the required 60-day development period.
- Collaborate with Disability Review Team Counselors regarding case documentation, disability criteria, and case recommendations.
- Refer completed cases to the Disability Review Team for review and determination.
- Enter case outcomes into the designated computer systems and issue allowance or denial notices within required timelines.
- Support monthly reporting requirements through accurate data entry and case tracking.
- Demonstrate professionalism, accountability, flexibility, and a commitment to providing excellent customer service.
- Attend meetings, trainings, and other assigned activities.
- Perform other related duties as assigned.
Required Skills/Abilities:
- Strong ability to multi-task in a fast-paced environment.
- Excellent organizational and time management skills.
- Strong analytical and problem-solving abilities.
- Ability to research and resolve issues related to obtaining medical records and required documentation.
- Excellent verbal, written, and interpersonal communication skills.
- Ability to work independently with minimal supervision.
- Strong customer service and telephone communication skills.
- Ability to manage multiple cases simultaneously while meeting established deadlines.
- High attention to detail and commitment to accuracy.
- Proficiency with Microsoft Word, Excel, and computer-based case management systems.
- Ability to maintain confidentiality and handle sensitive information appropriately.
EDUCATION/EXPERIENCE REQUIREMENTS:
- Bachelor's Degree preferred.
- Medical records, healthcare administration, case management, disability services, or related experience preferred.
- Experience obtaining, reviewing, and organizing medical documentation is highly desirable.
- Experience working with disability programs, Medicaid, healthcare providers, or social service programs is preferred.
- Strong computer skills, including Microsoft Word and Excel, required.
- Ability to meet deadlines and manage competing priorities in a high-volume environment.
Physical Requirements:
- Prolonged periods of sitting at a desk and working on a computer
- Standard hours of work Monday through Friday, 8:30 am – 4:30 pm
- Must maintain excellent attendance and punctuality
Successful ATHENA employees will display the following characteristics:
- You strive to be the best in your field currently and in the future.
- You like to make your employer look good.
- You find solutions, where others only see problems.
- You are proactive, you make and meet commitments, and you perform your duties exceedingly well.
- You are aware of the employer’s needs at all times and are well-versed in what you personally and ATHENA can offer them as a whole.
- You have the ability to work with diverse, integrated, deliverable-driven teams to accomplish the larger mission.
The benefits of working for ATHENA include a full Benefit package:
- Support from a team of professionals committed to making your life better.
- 15 days or 120 hours of PTO; carryover limit of 80 hours; for full-time positions.
- Medical, dental and vision insurance.
- Robust bonus structure paid twice per year.
- Medical and dependent flexible spending account.
- Pet insurance.
- 401k with a generous employer match.
- Easy to use employee self-serve HR portal.
The statements in this Job Posting are intended to describe the general nature and minimum level of work required. The content should not be construed as a complete list of all duties, responsibilities, and skills required to meet the criteria for this position. Upon request, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Application for employment is not intended to and does not create a contract or offer of employment and if hired, employment with the company is on an at-will basis and could be terminated at the will of either party.
ATHENA Consulting LLC does not discriminate in hiring based on federally protected classifications to include but not limited to race, color, religion, national or ethnic origin, sex, sexual orientation, gender identity or expression, age, disability, protected veteran status, marital status or other characteristics protected by law. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities.
#ATHENAJOBS-High
Pay: $20.00 - $23.00 per hour
Benefits:
- 401(k) matching
- Dental insurance
- Health insurance
- Vision insurance
Application Question(s):
- Do you have a Bachelor’s degree or equivalent experience in medical records, healthcare administration, case management, or disability services?
- Do you have experience obtaining, reviewing, and organizing medical documentation?
- Are you familiar with Medicaid disability programs or social service programs?
Work Location: In person
