Senior Medicaid Support Specialist

Wellpath•Franklin, TN

About The Position

The Senior Medicaid Support Specialist provides guidance and technical support to field staff on Medicaid enrollment and eligibility. The role communicates policy updates, escalates issues to leadership, and helps coordinate efforts between operations, utilization management, and claims. Responsibilities include analyzing financial impacts, preventing unnecessary offsite costs, and supporting compliance with Medicaid billing standards. The specialist assists with developing, maintaining, and reporting Key Performance Indicators (KPIs). They play a critical role in ensuring efficient billing processes and improving organizational reimbursement outcomes. Wellpath sees hundreds of thousands of unique individuals in their facilities month over month and a very large percent of those individuals receive direct clinical care, which includes lives saved by Narcan. We offer ongoing training and development opportunities for licensed and unlicensed healthcare team members, and have best in class clinical resources for training, education, and point of care support.

Requirements

Bachelor’s degree required.
3+ years of experience with Medicaid/Private insurance billing or enrollments.
3+ years of experience with analyzing data, creating reports, and converting for meaningful use for internal and external clients.
1-2 years of experience with payment integrity and recoupments experience.
1-2 years of experience with presentations and developing training materials.

Nice To Haves

Hospital billing experience preferred.

Responsibilities

Provide expertise and support to field staff on Medicaid enrollment and eligibility
Escalate issues and communicate changes in Medicaid policies to internal teams
Coordinate with operations, utilization management, and claims to prevent non-reimbursed costs
Assist with the development, maintenance, and communication of KPIs
Support process improvement initiatives related to Medicaid billing and reimbursements