Medicaid Benefits & Eligibility Specialist

Asbury Communities; Gaithersburg (MD); On-site; USD 65,000 - 75,000; Full time

Job summary

Asbury Methodist Village in Gaithersburg, MD is seeking a detail-oriented Benefits & Eligibility Coordinator to oversee Medicaid billing and resident eligibility. You will act as the Medicaid subject matter expert, ensuring compliance with state guidelines and supporting the financial health of our skilled nursing facilities.

You will manage applications, verify payer coverage before admission, lead the resident funds program, and help shape Medicaid policy updates to streamline processes.

Qualifications

• Bachelor’s degree or equivalent experience required.
• 2–5 years of Medicaid, Medicare, and third-party billing/application experience preferred.
• 1–2 years of accounting experience with computerized systems.
• Strong attention to detail, organization, and communication skills.
• Proficiency in Microsoft Office; comfort with databases/software systems.

Responsibilities

• Manage the Medicaid application and reapplication process for residents, including complex cases, ensuring compliance with regulations.
• Oversee intake and eligibility verification for Skilled Nursing Facilities, developing systems to confirm payer coverage before admission.
• Lead the resident funds program (RFMS) and banking system, ensuring timely and compliant processing of refunds and transactions.
• Track Medicaid Pending aging, support Facility Billing Counselors, and update resident income changes.
• Collaborate on collection activities, including monitoring Resident Responsibility Accounts Receivable and referring cases to outside agencies as needed.
• Guide policy development and updates related to Medicaid processes and ensure adherence to safety management standards.

Skills

Attention to detail

Organization

Communication skills

Microsoft Office

Database software

Education

Bachelor’s degree or equivalent experience

Accounting experience

Tools

Medicaid billing systems

Job description

Asbury Methodist Village in Gaithersburg, MD is seeking a detail-oriented Benefits & Eligibility Coordinator to oversee Medicaid billing and resident eligibility. You will act as the Medicaid subject matter expert, ensuring compliance with state guidelines and supporting the financial health of our skilled nursing facilities.

You will manage applications, verify payer coverage before admission, lead the resident funds program, and help shape Medicaid policy updates to streamline processes.