Medicaid Specialist

Medicaid Specialist

Job Summary:

We’re seeking a detail-driven Medicaid Specialist to support our skilled nursing facilities (SNFs) by ensuring accurate Medicaid billing, resolving reimbursement issues, and managing complex eligibility cases. This role is ideal for someone who thrives in a fast-paced environment, understands Medicaid processes deeply, and enjoys collaborating with facility teams to drive strong financial outcomes.

Essential Duties

• Manage and resolve complex Medicaid cases for SNF facilities
• Track Medicaid applications, approvals, redeterminations, and admit packs.
• Assist facilities with Medicaid applications, redeterminations, and admit packs.
• Communicate with residents or families regarding Medicaid documentation or application needs
• Document payer activity and follow-up using company-approved systems
• Collaborate closely with Business Office Managers on admit packs and pending applications
• Conduct monthly reviews with the Business Office Manager and Regional Business Office Mangers
• Prepare account write-offs when collection efforts are exhausted

What You Bring

• Experience with Medicaid billing, preferably in a skilled nursing or long-term care environment
• Strong understanding of Medicaid eligibility, authorization, and claims processes
• Ability to analyze account discrepancies and resolve complex billing issues