• The Assisted Living Waiver Program Care Coordination Agency (ALWP CCA) Office Coordinator is responsible for processing the ALWP beneficiary application as per Regulatory Agency and Libertana Home Health Policy. • Assists Medi-Cal beneficiaries in obtaining access to waiver services, state plan services and other community resources by identifying, coordinating and collecting data required for the ALWP application. • Responsible for the proper completion of all documents required for the State Waiver Program Application as per ALWP and Agency policy. • Reviews and evaluates the ALWP documents necessary for State Waiver Program Application, including Initial Assessments, Re-assessments, ISPs, Physicians Reports Medi-Cal eligibility, etc. • Discusses State inquiries or requests for documentation with Lead ALF Coordinator, ALF Manager, ALF Staff, SNFs and other referral sources. • Responsible for the completion of Patient Charts as per Agency policy. • Establishes and maintains good relationships with RCFE, SNFs and other vendors. • Assists the Agency in maintaining compliance with Federal, State, Local and HIPAA Regulations or Joint Commission Standards. • Assists facilities and ALF Care Coordinators in Habilitation Hours compliance. • Assures that assessments are performed and all necessary documents are completed. • Troubleshoots Client, RCFE, SNF and other vendor issues. • Follow up with RCFE managers, discharge planners and other appropriate client contacts who work there, establishing working relationships and educating them about the ALW Program the services available to them. • Exercises excellent judgement and knowledge of current ALF Care Coordination practices and procedures in alignment with Libertana Policy and DHCS ALWP Policy. • Participates in appropriate continuing education as may be required and/or required by your immediate supervisor. • Maintains a comfortable work environment for all employees. • Conforms to all agency policies and procedures. • Respects the patients and familys rights and property as defined by the federal and state laws. • Driving may be required to geographical areas that are covered by the company. • Knowledge of Confidentiality, HIPAA and healthcare laws and regulations. • Reports Fraud and Abuse. • Knowledge of mandated reporting. • Performs other duties as assigned.

• Investigate and resolve Medi-Cal eligibility barriers that prevent members from accessing services or disrupt reimbursement workflows • Conduct eligibility verification using state systems, EMR platforms, and insurance databases • Communicate with county eligibility workers to clarify case status and resolve pending or denied actions • Oversee and coordinate Medi-Cal redetermination submissions • Track redetermination cycles and proactively engage members • Contact members to gather required information and explain eligibility requirements • Build relationships with county Medi-Cal offices • Collaborate with internal departments including Member Services, Revenue Cycle, Clinical Teams, and Compliance • Maintain accurate, audit-ready documentation • Conduct in-person visits to county offices when necessary • Track and report eligibility trends and case outcomes • Driving will be required to county offices • Maintain confidentiality, HIPAA compliance, and knowledge of mandated reporting requirements • Uphold agency standards, policies, and procedures as outlined in the Employee Handbook • Participate in departmental meetings and trainings as required • Performs other duties as assigned

• Provides the highest company-wide level of technical claim-handling, including investigation, evaluation, and negotiations pertaining to Property, Collapse, Earth Movement and Total loss of building • Supports the team as technical supervisor in manager's absence • Assists with Regional audits • Mentors less experienced Claim Representatives • Performs other duties as required or assigned by the Claim Manager or Director

• Prepare, review, and submit accurate medical claims to insurance companies or government programs • Verify patient insurance coverage and eligibility for services • Process claims for reimbursement and ensure timely follow-up on denied or unpaid claims • Post payments, adjustments, and reconcile billing statements • Communicate with insurance companies to resolve claim discrepancies, rejections, or denials • Assist patients with billing inquiries and resolve payment issues • Ensure compliance with healthcare regulations and billing standards (e.g., HIPAA, ICD-10, CPT) • Maintain detailed records of billing activities and update patient billing information regularly