Medicaid Specialist

St Camillus Residential Health•Syracuse, NY

2d•$22 - $26•Onsite

About The Position

St. Camillus is seeking a Full Time Medicaid Specialist to join their Patient Financial Services Team. This is an on-site position focused on managing Medicaid applications and ensuring financial liability for residents. The role involves working closely with patients, families, and internal departments to navigate Medicaid regulations and billing processes.

Requirements

Associate’s Degree
Experience in Medicaid Eligibility and/or Skilled Nursing Facility Medicaid billing.
Strong Microsoft Office experience (Word and Excel).
Strong verbal, written, computer, and leadership skills.
Must be a team player and able to build strong relationships with residents and their families.
Must be able to work independently managing multiple projects at once.

Responsibilities

Review insurance coverage with families to determine financial liability and/or need for Medicaid.
Determine estimated Net Available Monthly Income (NAMI).
Complete, monitor, and ensure timely submission of Medicaid applications and recertifications.
Maintain knowledge of third-party billing regulations.
Assist with day-to-day billing functions as needed.
Track Medicaid application submission deadlines and status.
Communicate with the local DSS office, St. Camillus staff, and residents/families to ensure timely approval and increased cash flow.
Obtain required documentation from families or financial institutions.
Complete and submit requested Medicaid forms and documents (e.g., LDSS 3559s, Nursing Home Account Sheets, PRIs).
Maintain accurate records of member's eligibility status, recertification dates, and MLTC provider.
Be knowledgeable on general skilled nursing facility payers and billing procedures.
Utilize financial reports to follow Private accounts that may need Medicaid.
Enter approved Medicaid information into the billing system for processing.
Report all Medicaid application issues to the PFS Manager, Director of Finance, and VP of Finance.
Provide written referral and backup documentation on Medicaid cases requiring attorney involvement.
Assist with any financial audits initiated by outside agencies (e.g., OMIG, Social Security).
Support department Manager, Director of Finance, and VP of Finance with required tasks.
Responsible for employee injury prevention, following safety rules and addressing safety issues with supervisor.
Perform other duties as assigned by supervisor.