Medicaid Specialist

Bear Mountain Healthcare; Massachusetts; On-site; USD 60,000 - 85,000; Full time

Benefits offered by this job

Medical/Dental/Vision

401(k) Retirement Plan

Life Insurance

Short Term Disability

Long Term Disability

Paid Sick/Vacation/PTO/Holidays

Employee Assistance Program

Employee Recognition Events

Job summary

Bear Mountain Healthcare in Massachusetts is seeking a full-time Medicaid Pending Specialist to assist in completing Medicaid applications, conversions, and reviews across multiple facilities.

Responsibilities include managing pending applications, re-determinations, denials, and reapplications, coordinating with the Business Office, and preparing reports for regional teams. Strong Medicaid knowledge and logistics are essential.

Qualifications

• Strong knowledge of the Medicaid application process and requirements.
• Must have strong organizational skills with high level notice of details.
• Good verbal and written communication skills.
• Must have reliable means of transportation.

Responsibilities

• Work Pending Medicaid applications and re-determinations to ensure financial eligibility.
• Process forms applicable to Massachusetts state requirements.
• Meet with residents/families per policy and monitor progress of cases.
• Communicate resident responsibility and discuss patient liability payments.
• Respond to denials and assist with appeals or reapplications.
• Collaborate with facility Business Office staff to coordinate approvals.
• Prepare reports and attend Medicaid Pending meetings with Regional team.

Skills

Medicaid knowledge

Organizational skills

Verbal and written communication

Transportation

Job description

Are you a Nursing Home Medicaid EXPERT?

Bear Mountain Healthcare is currently seeking a full time Medicaid Pending Specialist to assist in the completion of Medicaid applications, conversions, and reviews in various facilities in Massachusetts.

Duties include:

• Responsible for working Pending Medicaid applications and re-determinations in order to ensure financial eligibility.
• Processing of all appropriate forms applicable to the Massachusetts state requirements
• Meet and work with residents/families in timely manner, per policy
• Monitor and document the progress of the pending Medicaid cases
• Communicate resident responsibility, discuss Patient Liability payments, per policy
• Respond to denials, which may include attendance of appeals or submission of reapplication
• Work in collaboration with the facility Business Office staff to coordinate efforts to approval
• Prepare reports and attend Medicaid Pending meetings with Regional team

Requirements include:

• Strong knowledge of the Medicaid application process and requirements
• Must have strong organizational skills with high level notice of details
• Good verbal and written communication skills
• Must have reliable means of transportation

Benefits:

• Competitive salary based on experience
• Medical/Dental/Vision
• 401(k) Retirement Plan
• Life Insurance, Short Term & Long Term Disability
• Paid Sick/Vacation/PTO/Holidays
• EAP (Employee Assistance Program)
• Employee Recognition Events

Performance Platform

Since being founded, Bear Mountain has been a leader in the healthcare industry. Today, Bear Mountain is a beacon of innovation, quality, and success. This continued leadership is the result of our Team Members staying true to our Vision, Mission, and Values. We expect you to demonstrate these Values:

• Performance - We're passionate about delivering exceptional healthcare and guest experiences.
• Integrity - We do the right thing, all the time.
• Transparency – We’re open, honest and straightforward in everything we do.

Key Attributes

• Respect
• Honesty
• Communication

Bear Mountain Vision and Culture

Bear Mountain is a leading healthcare company, spanning the nursing home sector from Extended/Long Term Care and Short Term Rehabilitation to Neurobehavior Programs. Bear Mountain is dedicated to continuing its tradition of providing exceptional guest experiences across its facilities. Our vision “To exceed your expectation with the highest quality healthcare in a safe, clean, supportive and positive environment.” unites us as a team, our Team members put the CARE back into Healthcare, and, our amazing Team Members are at the heart of it all! We expect you to maintain and support the education of this culture.

Equal Opportunity Employer