Medicaid Eligibility & Applications Specialist

Premier-Washington; Chartiers Township (PA); On-site; USD 42,000 - 65,000; Full time

Job summary

Premier-Washington is seeking a Medicaid Specialist to manage timely Medicaid Pending applications, ensuring documentation is complete and accurate for processing in accordance with federal, state, and local standards. The role emphasizes confidentiality and HIPAA compliance while documenting all financial and resident information carefully.

You will work directly with residents, families, and the business office to secure documentation, coordinate with county offices, and support

Qualifications

• Two years of work experience in Long Term Care.
• Knowledge of Medicaid regulations, guidelines and best practices.
• Ability to speak and write effectively, with good communication and people skills.
• Aptitude for problem solving and maintaining confidentiality.

Responsibilities

• Ensure Medicaid Pending applications are completed timely with all required documentation.
• Educate residents and families about the Medicaid process and required documents.
• Coordinate with the Business Office to ensure HIPAA compliance and accurate billing information.
• Track MA51 and PASSAR to prevent clinical denials and ensure timely renewals.
• Forward OBRA letters when applicable and obtain necessary documentation from social services/admissions.
• Contact residents, families, and financial institutions daily to obtain verification for Medicaid grants.
• Support annual in-house Medicaid recertifications and coordinate with county offices.

Skills

Long Term Care experience

Confidentiality and HIPAA

Effective communication

Documentation and record-keeping

Job description

Premier-Washington is seeking a Medicaid Specialist to manage timely Medicaid Pending applications, ensuring documentation is complete and accurate for processing in accordance with federal, state, and local standards. The role emphasizes confidentiality and HIPAA compliance while documenting all financial and resident information carefully.

You will work directly with residents, families, and the business office to secure documentation, coordinate with county offices, and support