Medicaid Eligibility Specialist — Grants & SNF Compliance

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

Benefits offered by this job

Vacation, sick and holiday pay

ST/LT Disability Insurance

Tuition Reimbursement

Life Insurance

401K

Job summary

The Hermitage Healthcare is seeking an experienced Medicaid Eligibility Specialist to review and approve medical eligibility applications and ensure timely submission across multiple SNFs.

The role requires 5–7 years in long-term care or healthcare, a college degree preferred, and proficiency with Medicaid eligibility rules. Travel within the identified region is expected. We offer competitive compensation and comprehensive benefits.

Qualifications

• Proficient in state-specific Medicaid Eligibility Requirements & Application Process.
• Proficient in review of Medicaid Applications.
• Time and Priority Management.
• Ability to travel to multi-sites within an 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 for assigned SNFs 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 including 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 (Retro-adjustments, Write-off, Adjustments).
• Monitor SNF activity for potential applications, new applications, pending applications, approved applications, appealed applications, and re-determination of continuous eligibility.

Skills

Medicaid knowledge

Time management

Prioritization

Travel readiness

Education

College degree preferred

Job description

The Hermitage Healthcare is seeking an experienced Medicaid Eligibility Specialist to review and approve medical eligibility applications and ensure timely submission across multiple SNFs.

The role requires 5–7 years in long-term care or healthcare, a college degree preferred, and proficiency with Medicaid eligibility rules. Travel within the identified region is expected. We offer competitive compensation and comprehensive benefits.