Operations Support Specialist

Description

Job Title: Operations Support Specialist- Colorado

Department: Operations- Colorado

Reports To: Regional Director


Date: July 21, 2026

Job Summary:


The Operations Support Specialist is responsible for supporting the financial and funding integrity of services by ensuring Medicaid eligibility, waiver funding, billing resolution, and representative payee coordination are completed accurately and timely. This position serves as a liaison between operations, finance, counties, case management agencies, state systems, and other stakeholders to minimize funding disruption and support continuity of services.


This role proactively identifies and resolves issues that may impact Medicaid eligibility, waiver funding, billing, reimbursement, or other revenue sources while supporting organizational compliance and operational efficiency.


Essential Duties and Responsibilities:


Medicaid Eligibility & Benefits Management

• Monitor Medicaid renewal and redetermination timelines.
• Track eligibility status and required documentation.
• Coordinate with individuals served, providers, guardians, case managers, counties, social security, and state agencies to prevent loss of benefits.
• Lead the resolution of Medicaid eligibility issues and reinstatement efforts.
• Maintain accurate records related to eligibility and funding status.

Funding Authorization & County Coordination

• Process and track county funding approvals and service authorizations.
• Monitor funding start dates, end dates, and renewal requirements.
• Follow up on delayed authorizations and funding determinations.
• Coordinate with case management agencies and county departments regarding funding concerns.
• Escalate funding issues that may impact service delivery or reimbursement.

Accounts Receivable & Billing Support

• Review aging accounts receivable reports.
• Investigate denied, suspended, or unpaid claims.
• Coordinate corrective actions with operations, finance, and billing teams both internally and externally.
• Track resolution efforts and maintain documentation.
• Assist in reducing aged receivables and improving reimbursement timelines.

Representative Payee Coordination

• Complete and submit organizational representative payee applications to local Social Security offices.
• Monitor representative payee requirements and documentation.
• Coordinate with payees, guardians, families, and providers regarding benefit-related matters.
• Assist with resolving benefit payment issues that may impact services.
• Ensure required records and communications are maintained.

Revenue Protection & Funding Remediation

• Identify individuals at risk of losing Medicaid, waiver funding, Social Security benefits, or other funding sources.
• Develop and coordinate remediation plans.
• Collaborate with internal and external stakeholders to restore or preserve funding.
• Track outcomes and maintain documentation of resolution activities.
• Verify Medicaid eligibility, waiver enrollment, funding approvals, and reimbursement readiness prior to admission.
• Identify funding risks prior to service provision beginning.
• Complete enrollment processes within systems driven by state, county, or case management agencies.

Reporting & Monitoring

• Maintain tracking systems for eligibility, authorizations, denials, funding concerns, and remediation efforts.
• Generate reports for operational and executive leadership as requested.
• Analyze trends and identify recurring barriers impacting reimbursement or funding continuity.
• Monitor, track, and trend unit utilization against authorizations to prevent over-serving or overbilling and encourage service unit maximization.
• Recommend process improvements to strengthen financial and operational performance.

Operational Support

• Participate in audits, compliance reviews, and quality assurance activities.
• Assist with special projects related to funding, billing, eligibility, and operational performance.
• Perform other duties as assigned.

Qualifications and Experience:

• Must be at least 18 years of age.
• Experience in HCBS, Host Home, Shared Living, ICF, case management, or related human services programs.
• Experience working with Medicaid eligibility, waiver funding, billing, accounts receivable, or benefits administration.
• Experience coordinating with counties, state agencies, case management entities, or representative payees.
• Experience interpreting regulations and funding requirements.
• Valid driver's license and clear driving record in compliance with local, state, and federal regulations and Vista Care's best practices
• Must have a reliable personal vehicle
• Personal vehicle and personal liability insurance must always remain current and within policy limits as determined by Vista Care. Documentation of routine maintenance of a personal vehicle must be maintained and presented to Vista Care upon request
• Clear background check in compliance with local, state, and federal regulations and Vista Care's best practices
• Consistently demonstrate effective decision-making abilities, strong communication skills, and computer literacy.
• Fluency in oral and written English. Bilingual proficiency is a plus.
• Completion of/ or ability to complete State-mandated training and training identified by Vista Care as best practice. Required to maintain certification during tenure in role.
• Demonstrates ability to be a positive role model for individuals, employees, co-workers, and management.
• Working knowledge of Medicaid, HCBS waiver services, and long-term support systems.
• Understanding of funding authorizations, eligibility requirements, and reimbursement processes.
• Strong organizational skills and attention to detail.
• Ability to manage multiple deadlines and priorities.
• Proficiency with electronic records systems, spreadsheets, and reporting tools.
• Ability to maintain confidentiality and handle sensitive information.
• Demonstrates ability to comply with company policies, procedures, and upholds the Mission, Vision, and Values of the organization.
• Demonstrates ability to actively contribute to a harmonious working environment, and maintains good working relationships with co-workers, management, individuals, outside agencies, and others with whom they may engage with.

Education:

• High School Diploma or GED required
• A college or university degree or the equivalent required. Human, social, business, or similar fields preferred.

Working Conditions/Physical Requirements:


Physical Requirements:

• Requires repetitive manual and finger dexterity and eye- hand coordination; requires the ability to use all office equipment

Visual, hearing, and communication requirements:

• Requires corrected vision and hearing to normal range, with or without reasonable accommodation.
• Must be able to communicate verbally and in writing with all staff, other professionals, and individuals.
• Must be able to give and receive verbal and written instructions in English.

Work location:

• Primarily remote with some of the time spent in offices and/or home-like settings with varying degrees of background noise.
• This position will interact with individuals who are intellectually and developmentally disabled and may be frail or confused and have the potential for verbal or physical aggression.