Medicaid Pending Navigator for SNF

PAC; Ponte Vedra Beach (FL); On-site; USD 55,000 - 75,000; Full time

Job summary

PAC seeks a Medicaid Pending Resource to develop pending processes, track aging, and train office managers on best practices to improve cash flow.

You will manage a caseload from admission to approval, submit and follow up on applications with eligibility offices, and collect required financial, medical, and legal documents.

The role covers multiple Florida facilities, requires strong Excel and EHR skills (PointClickCare, MatrixCare), and strict adherence to Medicaid rules.

Qualifications

• Minimum four years’ experience in a Skilled Nursing Facility.
• Knowledge of Medicaid eligibility requirements; state-specific knowledge a plus.
• Experience with cash collections, bad debt and DSO.
• Experience with EHR/billing systems.
• Strong organizational and communication skills.
• Willing to travel to Florida facilities.

Responsibilities

• Track and manage a caseload of Medicaid Pending residents from admission through approval.
• Complete, submit, and follow up on Medicaid applications with eligibility offices.
• Coordinate with residents, families, and responsible parties to gather required documents.
• Communicate with facility staff to resolve eligibility issues.
• Monitor aging pending accounts and escalate stalled cases.
• Maintain records in resident management/billing system (PointClickCare, MatrixCare).
• Assist with spend-down documentation, resource assessments, and appeals when denied.
• Ensure compliance with Medicaid regulations and PAC policies.

Skills

Excel

PointClickCare

MatrixCare

Communication

Organization

Multi-tasking

Travel

Education

High school diploma

Associate's or Bachelor's degree preferred

Tools

PointClickCare

MatrixCare

Job description

PAC seeks a Medicaid Pending Resource to develop pending processes, track aging, and train office managers on best practices to improve cash flow.

You will manage a caseload from admission to approval, submit and follow up on applications with eligibility offices, and collect required financial, medical, and legal documents.

The role covers multiple Florida facilities, requires strong Excel and EHR skills (PointClickCare, MatrixCare), and strict adherence to Medicaid rules.