Medicaid Coordinator

Medicaid Coordinator

Reports To: Director of Accounts Receivable
Schedule: Full-Time, 40 hours per week, Monday through Friday, 8:00 AM to 4:30 PM (In-Office Position)
Pay Range: $26.00 to $32.00 per hour, depending on experience

*$1,500 Sign On/Retention bonus*
Position Summary

The Medicaid Coordinator is responsible for managing and monitoring the Massachusetts Medicaid (MassHealth) application process for residents from initial application through approval and ongoing eligibility maintenance. This role is also responsible for processing monthly Medicaid billing, resolving billing issues, and ensuring compliance with all MassHealth requirements.

The Medicaid Coordinator works closely with facility Business Office teams, residents, families, attorneys, and third-party representatives to facilitate successful Medicaid eligibility determination and reimbursement.
Education & Experience Requirements

• Associate degree preferred, or a minimum of three (3) years of equivalent work experience.
• Prior experience processing MassHealth insurance applications and Medicaid billing required.
• Experience in a nursing home or long-term care setting strongly preferred.

Key Responsibilities

• Process and monitor Medicaid billing and follow up on outstanding claims, denials, and reimbursement issues.
• Manage Medicaid reviews, redeterminations, and resident conversions.
• Meet with residents and family members to gather required documentation and provide guidance throughout the MassHealth application process.
• Ensure all required screenings, forms, and SC-1 documentation are completed accurately and submitted timely.
• Communicate resident financial responsibilities, including patient liability requirements.
• Monitor application status and follow up with state agencies, attorneys, guardians, and third-party administrators as needed.
• Oversee and track patient liability calculations and collections.
• Maintain accurate records and documentation related to Medicaid eligibility and billing.
• Collaborate with Business Office personnel to resolve issues that may impact eligibility, billing, or reimbursement.
• Ensure compliance with all MassHealth regulations, policies, and deadlines.

Qualifications

• Prior Medicaid billing experience required.
• Working knowledge of the Massachusetts MMIS system required.
• Demonstrated experience with the Massachusetts Medicaid (MassHealth) application process required.
• Prior experience in a nursing home, skilled nursing facility, or long-term care environment strongly preferred.
• Strong organizational, analytical, and problem-solving skills.
• Exceptional attention to detail and accuracy.
• Excellent verbal and written communication skills.
• Ability to manage multiple cases, deadlines, and priorities effectively.
• Proficiency with Microsoft Office applications and electronic billing systems.
• Reliable transportation and the ability to travel between facilities as needed.

Skills & Competencies

• Strong customer service and interpersonal skills.
• Ability to work independently while collaborating effectively with multiple stakeholders.
• Knowledge of healthcare reimbursement and Medicaid regulations.
• Ability to maintain confidentiality and handle sensitive financial and resident information professionally.
• Strong time-management and follow-through skills.

Benefits include but not limited to

• Health, Dental, Vision, Flexible Spending, & Life Insurance
• 401k with employer match.
• Generous earned time accrual
• Tuition Reimbursement

Why Work at Oriol Healthcare?

At Oriol Healthcare, we are committed to providing exceptional care and support to our residents while fostering a positive and collaborative work environment for our employees. As a family-owned organization with a long-standing reputation for excellence in skilled nursing and long-term care, we recognize that our success is driven by the dedicated professionals who make a difference every day.

When you join Oriol Healthcare, you'll enjoy:

• A supportive and team-oriented culture
• The opportunity to make a meaningful impact on the lives of residents and their families
• Competitive compensation based on experience
• Stable, full-time employment with a respected healthcare organization
• Opportunities for professional growth and development
• Collaboration with experienced healthcare, business office, and clinical professionals
• A workplace that values integrity, compassion, accountability, and excellence

As a Medicaid Coordinator, you will play a vital role in helping residents access the benefits and services they need while supporting the financial health of our facilities. If you're looking for a rewarding career where your expertise is valued and your work truly matters, we invite you to join the Oriol Healthcare team.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.