Medicaid Pending Process Lead

(PACS) Providence Administrative Consulting Services, Inc.; Florida; Hybrid; USD 60,000 - 80,000; Full time

Job summary

PACS Providence Administrative Consulting Services, Inc. is seeking a Medicaid Pending Resource to develop pending processes, train office managers, and run weekly aging reviews across Florida facilities.

You will manage caseloads from admission to approval, coordinate with families, gather documentation, and ensure accurate records in PointClickCare and MatrixCare. Travel to facilities statewide is required.

Qualifications

• Minimum four years’ experience in a Skilled Nursing Facility.
• Knowledge of Florida Medicaid eligibility requirements.
• Proven success in cash collections, bad debt, and DSO.
• Experience with Medicaid spend-down, trusts, and asset transfers.
• Experience with EHR/billing systems (PointClickCare preferred).

Responsibilities

• Track and manage a caseload of Medicaid Pending residents from admission through Medicaid approval.
• Complete, submit, and follow up on Medicaid applications with state/county eligibility offices.
• Coordinate with residents, families, and responsible parties to gather required documentation.
• Communicate regularly with facility Business Office Managers, Admissions, and Social Services to resolve eligibility issues.
• Monitor and report on aging pending accounts; reduce time-to-approval.
• Maintain accurate records in resident management/billing system (PointClickCare, MatrixCare).
• Ensure compliance with state Medicaid regulations and PACS policies.
• Partner with Medicaid caseworkers and eligibility agencies to expedite determinations.
• Assist in spend-down documentation and appeals when applications are denied.
• Proficient in Excel and PCC.

Skills

Medicaid Knowledge

Cash Collections

DSO

EHR Systems

Excel

PointClickCare

Communication

Multi-facility

Education

High School Diploma

Associate's Degree

Bachelor's Degree

Tools

PointClickCare

MatrixCare

Excel

Job description

PACS Providence Administrative Consulting Services, Inc. is seeking a Medicaid Pending Resource to develop pending processes, train office managers, and run weekly aging reviews across Florida facilities.

You will manage caseloads from admission to approval, coordinate with families, gather documentation, and ensure accurate records in PointClickCare and MatrixCare. Travel to facilities statewide is required.