Senior Medicaid Specialist
About The Position
The vision of Smile Doctors is our people-first culture which creates an environment of passionate, caring Team Members dedicated to providing fun and encouraging relationships with each other and our patients. Smile Doctors offers every Team Member the opportunity to be a part of something bigger. We focus on the importance of the individual and recognize that each person on our Team has something great to offer. We recognize talents and strengths and take care to nurture those abilities to help our Team Members grow into successful people in their careers, in our organization, and beyond. Looking for a position that makes you smile? We’re seeking a Sr. Medicaid Specialist to join our growing team. The Sr. Medicaid Specialist is responsible for Medicaid development, compliance, credentialing and payor enrollment processes. This position will bridge tactical execution and strategic alignment to drive department Medicaid goals.
Requirements
- Strong policy writing and process improvement skills
- Strong analytical and problem-solving abilities
- Strong oral and written communication skills
- High School diploma or equivalent required
- Five (5) years of experience in revenue cycle management, claims, or service access required with two (2) of those years in Orthodontics insurance or billing preferred
- Experience with Medicaid and commercial payor enrollment across multiple states preferred
- Intermediate proficiency in Microsoft Excel and SharePoint
Responsibilities
- Monitor and interpret federal and state Medicaid dental regulations
- Conduct research on Medicaid updates, reimbursement models, and best practices
- Draft Medicaid development requests to ensure system functionality
- Draft Medicaid policies and procedures
- Analyze Medicaid data to identify trends in access barriers or regulatory shifts
- Support manager in ensuring organizational practices align with current Medicaid guidelines
- Mentor the Medicaid Specialist
- Serve as a subject matter expert on Medicaid dental coverage and policy changes
- Maintain up-to-date knowledge of eligibility criteria and renewal procedures
- Track enrollment timelines
- Act as a resource for clinics and provide training on Medicaid procedures and best practices
- Provide customer service for billing inquiries and assist with their documentation
- Assist in training clinic team members on Medicaid processes and update
- Liaison with Medicaid Advocates for guidance and clarification on Medicaid processes
Benefits
- Competitive salary
- Medical, dental, vision and life insurance
- Short and long-term disability coverage
- 401(k) plan
- 3 weeks paid time off in your first year + paid holidays
- Discounts on braces and clear aligners for you and your family members
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
Number of Employees
1,001-5,000 employees
