About The Position
The Regional Medicaid Application Specialist manages Medicaid applications and recertification's for residents across multiple skilled nursing facilities within a region. This role ensures timely and accurate submissions, minimizing Medicaid Pending and Accounts Receivable exposure. The Specialist serves as the primary expert and liaison for Medicaid eligibility, collaborating with residents, families, facility staff, and government agencies.
Requirements
- Education: Bachelor’s degree in Business, Finance, Social Work, or related field preferred.
- Experience: 3–5 years managing Medicaid applications in long-term or post-acute care; regional/multi-facility experience a plus.
- Knowledge: Expert knowledge of state Medicaid long-term care eligibility; familiarity with Medicare, Managed Long-Term Care, and other payers is highly desirable.
- Requires frequent regional travel to various skilled nursing facilities.
- Must be able to work in a typical office setting and interact professionally with residents, families, and governmental agencies.
- May require sitting for extended periods and performing data entry tasks.
Responsibilities
- Oversee the full Medicaid application lifecycle, including initial applications and annual recertification.
- Conduct interviews and financial reviews with residents and responsible parties to gather required documentation.
- Prepare and submit accurate applications to state agencies within regulatory deadlines.
- Liaise with government caseworkers, respond to RFIs, and resolve complex cases, denials, and appeals.
- Maintain up-to-date knowledge of federal, state, and local Medicaid regulations.
- Ensure accurate record-keeping in electronic and physical files, adhering to HIPAA and company policies.
- Document case notes, deadlines, and resident payer status in EHR and financial software (e.g., PointClickCare).
- Train and guide facility staff on Medicaid application procedures and documentation requirements.
- Travel within the region for support, document collection, and internal compliance auditing.
- Generate reports for leadership on Medicaid Pending accounts, recertification deadlines, and A/R exposure.
- Collaborate with billing specialists to ensure accurate patient liability management and claim processing.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
