Senior Medicaid Specialist

Smile Doctors•Dallas, TX

About The Position

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. How you’ll make us better: 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 functionalityDraft 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 timelinesAct 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

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