Medicaid Pending Specialist & Training Lead

PACS; Lorida (FL); On-site; USD 45,000 - 65,000; Full time

Job summary

PACS, a healthcare provider in Florida, seeks a Medicaid Pending Resource to oversee Medicaid pending aging and guide office managers on best practices for cash collections, DSO, and bad debt. The role includes weekly aging reviews and close collaboration with Medicaid offices and facility teams.

The candidate will handle income eligibility, spend-down documentation, and appeals, while ensuring compliance with Florida Medicaid rules and PACS policies. Travel to Florida facilities is required.

Qualifications

• Experience in Skilled Nursing Facility operations.
• Proven success in Medicaid eligibility and cash collection.
• Familiarity with Medicaid spend-down, assets, and asset transfer rules.
• 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 (financial, medical, legal).
• Communicate regularly with facility Business Office Managers, Admissions, and Social Services to resolve outstanding eligibility issues.
• Monitor and report on aging pending accounts; escalated stalled cases to reduce time-to-approval.
• Maintain accurate, up-to-date records in the resident management/billing system (e.g., 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, resource assessments, and appeals when applications are denied.

Skills

Excel

Education

High School Diploma

Associate or Bachelor’s degree preferred

Tools

PointClickCare

Job description

PACS, a healthcare provider in Florida, seeks a Medicaid Pending Resource to oversee Medicaid pending aging and guide office managers on best practices for cash collections, DSO, and bad debt. The role includes weekly aging reviews and close collaboration with Medicaid offices and facility teams.

The candidate will handle income eligibility, spend-down documentation, and appeals, while ensuring compliance with Florida Medicaid rules and PACS policies. Travel to Florida facilities is required.