Regional Medicaid Specialist

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Regional Medicaid Specialist Full Time Falls Church, VA, US 4 days ago Requisition ID: 1169 Position: Regional Medicaid Specialist – Skilled Nursing Facility Major Duties and Responsibilities Medicaid Program Support Serve as a regional expert on assigned state Medicaid policies, procedures, and eligibility requirements. Monitor pending Medicaid applications and follow up with facility staff and the local and state Medicaid agencies. Assist staff and residents with Medicaid enrollment, renewals, and benefit questions. Track eligibility determination dates and maintain accurate records of approvals, denials, and renewals. Monitor changes to state Medicaid regulations and communicate updates to stakeholders. Support managed care operations and Medicaid waiver programs. Build and maintain relationships with healthcare providers, community organizations, and state agencies. Conduct outreach and training sessions regarding Medicaid processes and compliance standards. Assist providers with credentialing, billing questions, prior authorizations, and claims resolution. Insurance & Billing Coordination Work closely with the billing department to ensure accurate payer source information. Coordinate benefits between Medicare, Medicaid, managed care plans, hospice, and private insurance. Assist with resolving claim denials due to eligibility issues. Communicate payer changes promptly to appropriate departments. Communication & Customer Service Serve as a liaison between residents, families, facility staff, and Medicaid agencies. Explain Medicaid processes and requirements in a professional and compassionate manner. Respond promptly to inquiries regarding Medicaid status and coverage. Collaborate with Business Office, admissions, social services, therapy, and nursing departments to support resident care and financial planning. Required Qualifications Bachelor’s degree in Business Administration, Healthcare Administration, Finance, or Social Work. LTC/SNF Experience: Minimum of 3 to 5 years of direct experience managing the long‑term care Medicaid application process inside an SNF. Multi‑Facility Management: Demonstrated background in a regional, corporate, or consulting capacity overseeing multiple business office managers (BOMs). Revenue Cycle Management: Proven success handling accounts receivable, medical billing, collections, and patient liability (share of cost) tracking. Additional Requirements Must be able to perform the physical requirements of the position. Benefits 7 Paid Major Holidays Generous PTO Medical, Dental and Vision Company Paid Life & AD&D Insurance & LTD Voluntary Life Insurance 401(k) immediate enrollment with match Tuition Reimbursement (up to $2,500 annually) Referral Bonus Program (up to $1,000) Vierra Communities provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements Vierra Communities complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. #J-18808-Ljbffr Vierra Communities