Medicaid & Insurance Authorization Specialist (Hybrid)

careadvantagecorporaterecruiting; Richmond (VA); Hybrid; USD 48,000 - 66,000; Full time

Benefits offered by this job

Competitive compensation

Comprehensive benefits

Career growth opportunities

Job summary

Care Advantage, Inc. in Richmond, VA is seeking an Insurance Specialist to manage Medicaid verifications, authorizations, and payer communications, ensuring timely services for clients.

The role demands highly organized, detail-oriented professionals with strong verbal and written communication skills who can collaborate with families, social services, and clinical teams in a hybrid work environment.

Qualifications

• High School Diploma or GED required.
• Strong administrative and organizational skills.
• Excellent verbal and written communication abilities.
• Proficiency with Microsoft Office applications.
• Ability to analyze information and maintain accurate records.

Responsibilities

• Manage Medicaid and Long-Term Care Insurance authorizations from start of care through discharge.
• Submit, extend, renew, and update authorizations as client needs change.
• Verify insurance coverage and eligibility prior to service initiation.
• Navigate insurance, Medicaid, MCO, and Atrezzo portals to obtain and maintain approvals.
• Communicate with families, social service agencies, healthcare plans, and internal teams regarding eligibility and authorization requirements.
• Monitor authorization status and proactively resolve payer-related issues.
• Maintain accurate client records and documentation.
• Build positive relationships with managed care organizations and payer partners.
• Support billing and compliance requirements through timely and accurate documentation.
• Collaborate with branch and clinical teams to ensure seamless service delivery.
• Assist with special projects and other duties as assigned.

Skills

Highly organized

Strong communicator

Customer-focused

Relationship building

Multi-tasking

Education

High School Diploma or GED

Associate degree

Tools

Microsoft Office

Job description

Care Advantage, Inc. in Richmond, VA is seeking an Insurance Specialist to manage Medicaid verifications, authorizations, and payer communications, ensuring timely services for clients.

The role demands highly organized, detail-oriented professionals with strong verbal and written communication skills who can collaborate with families, social services, and clinical teams in a hybrid work environment.