Medicaid Pending Specialist & Training Lead (Florida)

PACS; United States; Remote; USD 55.000 - 75.000; Vollzeit

Zusammenfassung

PACS is seeking a Medicaid Pending Resource to develop a Medicaid pending process and train office managers in best practices for Medicaid pending cases. You will review aging patterns weekly and target training where issues arise, ensuring compliance with Florida Medicaid and PACS policies.

The role requires managing caseloads through approval, coordinating with residents and facilities, and leveraging systems like PointClickCare and Excel to maintain accurate records and improve cash

Qualifikationen

• Minimum of four years’ experience in a Skilled Nursing Facility
• Experience with Medicaid eligibility requirements (state-specific knowledge a plus)
• Proven success in cash collections, bad debt and DSO
• Experience with EHR/billing systems (PointClickCare preferred)
• Strong organizational skills with ability to manage a high-volume caseload
• Ability to multi-task across programs and facilities
• Excellent communication with families, state agencies, and internal stakeholders
• High school diploma required; associate’s or bachelor’s degree preferred
• Must be flexible and travel to different facilities located in Florida
• Leadership abilities to promote a positive work environment while teaching/training
• Effective time management and attention to detail
• Experience in multi-facility or corporate long-term care environment
• Familiarity with Medicaid spend-down, trusts, and asset transfer rules
• 2+ years of Medicaid eligibility, long-term care billing, or skilled nursing preferred

Aufgaben

• Track and manage a caseload of Medicaid Pending residents from admission through approval
• Submit and follow up on Medicaid applications with eligibility offices
• Coordinate with residents, families, and responsible parties for required documentation
• Communicate with Business Office Managers, Admissions, and Social Services to resolve eligibility issues
• Monitor aging pending accounts and expedite stalled cases to reduce time-to-approval
• Maintain accurate records in resident management/billing systems (PointClickCare, PCC)
• Ensure compliance with state Medicaid regulations and PACS policies
• Partner with Medicaid caseworkers to expedite determinations
• Assist in spend-down documentation and appeals when necessary
• Proficient in Excel and PCC

Kenntnisse

Medicaid eligibility

Cash collections

DSO reduction

Communication

Time management

Ausbildung

High school diploma

Associate’s or bachelor’s degree preferred

Tools

PointClickCare

Excel

Jobbeschreibung

PACS is seeking a Medicaid Pending Resource to develop a Medicaid pending process and train office managers in best practices for Medicaid pending cases. You will review aging patterns weekly and target training where issues arise, ensuring compliance with Florida Medicaid and PACS policies.

The role requires managing caseloads through approval, coordinating with residents and facilities, and leveraging systems like PointClickCare and Excel to maintain accurate records and improve cash