Hybrid Remote Business Office Manager (NY Medicaid Specialist)

Job Description

Job Description

Hybrid Remote Business Office Manager (NY Medicaid Specialist)

Salary: $120,000 per year

Benefits:

• Medical, Dental, Vision Insurance

• Life Insurance

• Disability Insurance

• 401K

• Paid Time Off

The Remote Business Office Manager is responsible for the end-to-end lifecycle of New York State Nursing Home Medicaid applications. This role focuses on securing facility reimbursement by navigating the complexities of local Departments of Social Services (DSS/HRA), managing the 5-year lookback process, and ensuring all resident income is properly diverted.

• Medicaid Lifecycle Management: Oversee all new NY Medicaid applications from initial filing through the "Notice of Decision," coordinating closely with corporate billing teams.

• Virtual Enrollment: Conduct remote intake meetings with families/responsible parties via phone or video to review financial obligations and secure necessary documentation.

• Documentation & Lookback: Expertly audit financial records for the 5-year lookback period; identify and resolve potential penalty periods or transfers of assets.

• Revenue Management: Facilitate the "Social Security Income Turnover" and complete Representative Payee forms to ensure Net Available Monthly Income (NAMI) is directed to the facility.

• Regulatory Compliance: Maintain rigorous knowledge of NYS DOH guidelines, including Resource Allowances , Spousal Impoverishment rules, and Pooled Trusts .

• Remote Administration: Manage "Triple Check" processes virtually and coordinate with on-site facility staff to ensure all mail and physical documents are digitized and processed.

• PNA & Trust Accounts: Oversee Resident Trust Funds (PNA) in compliance with state and federal regulations.

• NY Medicaid Expertise: Deep understanding of the New York State Medicaid application process (specifically for Long Term Care).

• Digital Proficiency: Advanced skills in document management systems, EMR software (e.g., PointClickCare, MatrixCare), and virtual meeting platforms.

• High-Volume Management: Ability to manage a large caseload across multiple NY counties or facilities simultaneously.

• Communication: Exceptional interpersonal skills to guide stressed family members through complex financial disclosures remotely.

• Experience: Minimum 3–5 years of experience in NY Nursing Home Medicaid billing or admissions.

• Confidentiality: Strict adherence to HIPAA and the ability to handle sensitive financial data in a remote environment.

• Independence: Proven ability to work autonomously, meet strict state deadlines, and problem-solve without direct on-site supervision.

• Organization: Masterful ability to track "Pending" statuses and follow up with caseworkers at various DSS/HRA offices.