Medicaid Benefits Coordinator

PRESTIGE HEALTHCARE RESOURCES INC • Washington, DC

14d

About The Position

As the Medicaid Benefits Coordinator, you will help Consumers apply for, secure, and maintain Medicaid benefits—ensuring timely access to care and preventing lapses in coverage. Your work directly impacts service continuity, billing accuracy, and Consumer satisfaction.

Requirements

• High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred.
• 1–2 years of experience in Medicaid eligibility, insurance navigation, benefits coordination, or case management.
• Strong familiarity with DC Medicaid, MCO processes, DHS requirements, and public benefits systems (strongly preferred).
• Experience with EHR systems and Microsoft Office Suite.
• Excellent organizational skills, accuracy, and attention to detail.
• Strong communication, customer service, and problem-solving skills.
• Ability to maintain confidentiality, professionalism, and Consumer trust.
• Ability to work independently and collaboratively within multidisciplinary teams.

Responsibilities

• Assist Consumers with completing new Medicaid applications and renewals.
• Guide Consumers through documentation requirements and submission steps.
• Educate Consumers on eligibility rules, MCO choices, renewal cycles, and timelines.
• Communicate with DHS, Medicaid offices, and MCO representatives as needed.
• Monitor Medicaid status and track upcoming expirations or risks of termination.
• Proactively contact Consumers to address pending renewals or missing documents.
• Resolve issues such as verification delays or eligibility discrepancies.
• Confirm application statuses, reinstatements, or corrections with DHS/MCOs.
• Maintain accurate Medicaid records within the EHR.
• Document all interactions and outcomes according to DC MHRS and HIPAA standards.
• Track approvals, lapses, reinstatements, and MCO enrollment changes.
• Provide clear, compassionate, step-by-step guidance throughout the Medicaid process.
• Assist Consumers facing barriers such as limited documentation or difficulty navigating systems.
• Work with intake, billing, clinical, and administrative teams.
• Notify staff when Medicaid issues impact service eligibility or billing.
• Partner with billing teams to reduce denials related to lapses or incorrect data.
• Investigate and resolve coverage discrepancies or unexpected terminations.
• Communicate with DHS, MCOs, and partner agencies to troubleshoot complex cases.
• Track unresolved issues and provide consistent follow-up until resolved.
• Follow all DC Medicaid, MCO, DHS, and agency guidelines.
• Generate reports on Medicaid status, renewals, and unresolved issues.
• Support audits through accurate, compliant documentation.
• Keep staff informed of policy changes.
• Recommend workflow enhancements and participate in Medicaid-related trainings.

Benefits

• Mission-driven work: Your efforts ensure Consumers have uninterrupted access to essential behavioral health services.
• Impact you can see: Preventing Medicaid lapses directly improves service delivery, billing accuracy, and client outcomes.
• Supportive team culture: Work collaboratively with intake, billing, and clinical teams who value communication and partnership.
• Professional development: Grow your expertise in Medicaid systems, managed care processes, and agency operations.
• Community-focused organization: Prestige is committed to empowering individuals, families, and communities through accessible, quality behavioral healthcare.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED