Eligibility Specialist

• Role: Manage Illinois Medicaid income adjustments and liability updates across MEDI, ABE, RFMS, and PointClickCare (PCC) platforms
• Location: Lincolnwood, IL office, with remote or hybrid options available for Illinois residents who have experience working in the systems listed
• Required: 2+ years of Medicaid billing experience in a care facility (SNF/Long-Term Care) or medical billing company
• Benefits: Full health, vision, and dental coverage; 401(k) retirement plan; Paid Time Off (PTO)
• Pay: $24.00 - $29.00/hour 

About Lyric National

At Lyric National Inc., we're rewriting the script for long-term care, providing skilled nursing facilities with a single-source concierge platform, and residents with access to robust medical options that enhance their quality of in-facility care. We are committed to improving healthcare access and financial sustainability, serving as a dedicated advocate in building the standard of senior care.

Job Overview

We are seeking a  Medical Billing Specialist (Medicaid) with deep technical expertise in Illinois Medicaid systems to lead our Lincolnwood office operations. This is a specialized role requiring a subject matter expert who understands the nuances of resident income liability and adjustments. You will be responsible for the integrity of our billing processes while simultaneously identifying operational gaps to build more efficient office workflows.

Core Responsibilities:

• Medicaid Income Specialist : Act as the primary Subject Matter Expert (SME) for Medicaid income adjustments including the complexities of income liability to ensure residents are correctly assessed and facilities are accurately reimbursed
• Medical Electronic Data Interchange (MEDI) : Own the end-to-end process within the Illinois MEDI system, ensuring all resident data, eligibility, and liability updates are processed without error
• Application For Benefits Eligibility (ABE) : Gather and upload all necessary documents into the ABE platform pertaining to all income adjustments
• Resident Fund Management Service (RFMS) : Accurately log all new financial details to RFMS regarding updated resident income
• PointClickCare (PCC) : Submit updated resident records and adjustments into PCC
• Strategic Advocate : Collaborate with the Sales team during facility onboarding to provide technical billing guidance and assist in the onboarding of new partners

Job Description:

Key Responsibilities:

• Technical Income Processing: Execute daily income adjustments for Medicaid patients, specifically focusing on adjusting income liability through the MEDI system
• Enrollment Liaison: Act as the technical billing lead during the facility onboarding process
• Workflow Engineering: Proactively identify gaps in current billing procedures and implement refined processes (e.g., creating a new supply request workflow or a streamlined income-adjustment audit)
• Continuous Learning: Rapidly adopt and integrate new systems, internal processes, and state regulatory updates within a fast-paced environment

Job Requirements:

• Education: High school diploma or equivalent
• Experience: 2+ years of experience in Medicaid billing, within a care facility (i.e., Skilled Nursing Facility (SNF), Long-Term Care...etc.), or medical billing company
• Operational Expertise: Strong knowledge of SNF operations to support complex billing and administrative workflows
• Technical Skills: Expert in processing income adjustments through the Medical Electronic Data Interchange (MEDI) system portal, working with Application For Benefits Eligibility (ABE) , Resident Fund Management Service (RFMS) , and PointClickCare (PCC) , Microsoft Office Suite, and experience with CRM tools (Salesforce preferred)
• Professional Mindset: A self-starter capable of working autonomously while maintaining high levels of collaboration with stakeholders

Preferred Qualifications:

• Education: Associate or Bachelor's degree
• Experience: Previous Healthcare administrative, finance, accounts receivable, or operations experience within care facilities (i.e., Skilled Nursing Facilities (SNF), Hospice Care, Physical Therapy, Home Help or Hospitals)

Benefits:

• Health Insurance
• Dental & Vision Coverage
• Paid Time Off (PTO)
• 401(k) Retirement Plan