Medicaid Eligibility & Grants Coordinator

Hermitage Skilled Nursing; Mill Street (MA); On-site; USD 60,000 - 90,000; Full time

Benefits offered by this job

Vacation and holiday pay

Disability insurance

Tuition reimbursement

Life Insurance

Job summary

Next Step Healthcare is seeking a Medicaid Eligibility Coordinator to review, approve, and submit Medicaid financial eligibility applications for multiple SNFs. This role requires coordination with county representatives, timely processing, and escalation when needed.

The candidate should have 5–7 years in long-term care or a related field, with knowledge of state Medicaid requirements and strong time-management skills. Travel to various sites within the region is expected.

Qualifications

• College degree preferred with 5–7 years in long-term care or county agency experience.
• Accounting, Insurance, Paralegal experience may be transferable.
• Proficient in state-specific Medicaid eligibility requirements and application process.
• Proficient in review of Medicaid applications.
• Time and priority management.
• Ability to travel to multi-sites within identified region.

Responsibilities

• Review and approve all Medical Eligibility Applications prior to submission.
• Review, approve, and submit every Medicaid Financial Eligibility Application and attached documentation for assigned SNFs.
• Proactively contact County representative to assure applications are progressing and expedite requests for additional information.
• Interface with customer or representative to secure new grants and to maintain grant status (Eligibility Re-Determinations).
• Determine response to Grant Discontinuation and/or Denials. Lead response, which may include Appeal, Re-Application, or Acceptance.
• Recommend legal or outsourced services to Administrator. May liaise on behalf of SNF.
• Communicate billing requirements to SNF based on Grant Approval or Denial, e.g. Retro-adjustments, Write-off, Adjustments.
• Monitor SNF activity for potential applications, new applications, pending applications (with A/R balances), approved applications, appealed applications, and re-determination of continuous eligibility application.
• Work with SNF to mitigate NSHC financial risk associated with Uncooperative Customers, Process Breakdown, and Administrator Escalations.

Skills

Medicaid Eligibility Knowledge

Medicaid Application Review

Time & Priority Management

Multi-site Travel

Education

College degree preferred

Job description

Next Step Healthcare is seeking a Medicaid Eligibility Coordinator to review, approve, and submit Medicaid financial eligibility applications for multiple SNFs. This role requires coordination with county representatives, timely processing, and escalation when needed.

The candidate should have 5–7 years in long-term care or a related field, with knowledge of state Medicaid requirements and strong time-management skills. Travel to various sites within the region is expected.