Medicaid Specialist

HireCare LLC; Warwick (RI); On-site; USD 85,000 - 95,000; Full time

Benefits offered by this job

Full-time position

Supportive environment

Ownership of Medicaid operation

Growth opportunities

Job summary

HireCare Services in Rhode Island seeks an experienced Medicaid Specialist to oversee pending Medicaid cases from application through approval. The role requires 5–7+ years of Medicaid/BOM experience, meticulous case management, and proactive follow-up to ensure timely processing.

The successful candidate will manage high-volume workloads, coordinate with residents, families, and agencies, and maintain precise Medicaid records.

Qualifications

• 5–7+ years of Medicaid and/or BOM experience required.
• Strong knowledge of Medicaid eligibility, applications, documentation, and processes.
• Experience managing pending Medicaid applications and a high-volume caseload preferred.
• Skilled in tracking applications and following up on outstanding documentation.

Responsibilities

• Oversee and manage all pending Medicaid applications and cases.
• Follow up consistently on pending applications, outstanding documentation, and eligibility requirements.
• Monitor each case from application through Medicaid approval.
• Review applications and supporting documentation for accuracy and completeness.
• Identify missing information, outstanding requirements, and potential delays.
• Communicate with residents, families, Medicaid agencies, facilities, and other involved parties.
• Track case status, deadlines, documentation requests, and follow-up activity.
• Maintain accurate and up-to-date Medicaid records and case notes.
• Proactively address issues that may delay Medicaid approval.
• Provide regular updates regarding pending Medicaid cases and outstanding items.
• Coordinate with business office and administrative teams to ensure efficient Medicaid processing.
• Ensure timely and thorough follow-up on all open Medicaid cases.
• Stay current on Medicaid requirements, regulations, and application processes.
• Take full ownership of the Medicaid pipeline and drive cases toward resolution.

Skills

Medicaid knowledge

Case management

Attention to detail

Time management

Communication

Independent work

Job description

HireCare Services is partnering with a leading healthcare organization in Rhode Island to recruit an experienced Medicaid Specialist to oversee pending Medicaid cases and ensure timely, consistent follow-up from application through approval.

The ideal candidate will have 5–7+ years of Medicaid and/or Business Office Manager (BOM) experience and a strong understanding of Medicaid applications, eligibility, documentation, and case management. This position is ideal for a highly organized, detail-oriented professional who takes ownership of their workload and ensures that no pending Medicaid case is left without proper follow-up.

Responsibilities

• Oversee and manage all pending Medicaid applications and cases

• Follow up consistently on pending applications, outstanding documentation, and eligibility requirements

• Monitor each case from application through Medicaid approval

• Review applications and supporting documentation for accuracy and completeness

• Identify missing information, outstanding requirements, and potential delays

• Communicate with residents, families, Medicaid agencies, facilities, and other involved parties

• Track case status, deadlines, documentation requests, and follow-up activity

• Maintain accurate and up-to-date Medicaid records and case notes

• Proactively address issues that may delay Medicaid approval

• Provide regular updates regarding pending Medicaid cases and outstanding items

• Coordinate with business office and administrative teams to ensure efficient Medicaid processing

• Ensure timely and thorough follow-up on all open Medicaid cases

• Stay current on Medicaid requirements, regulations, and application processes

• Take full ownership of the Medicaid pipeline and drive cases toward resolution

Qualifications

• 5–7+ years of Medicaid and/or Business Office Manager (BOM) experience required

• Strong knowledge of Medicaid eligibility, applications, documentation, and processes

• Experience managing pending Medicaid applications and a high-volume caseload preferred

• Skilled in tracking applications and following up on outstanding documentation

• Strong organizational and time-management skills

• Excellent attention to detail and follow-through

• Strong written and verbal communication skills

• Ability to work independently and take ownership of responsibilities

• Strong problem-solving skills

• Healthcare, skilled nursing, long-term care, or related experience preferred

What We Offer

• $85,000–$95,000 annual salary

• Full-time position

• Supportive and collaborative work environment

• Opportunity to take ownership of a critical Medicaid operation

• Professional growth and development opportunities

• Work alongside an experienced healthcare operations team

What We Are Looking For

We are looking for an experienced Medicaid Specialist who is highly organized, proactive, and experienced in managing Medicaid applications and pending cases. The ideal candidate understands the importance of consistent follow-up, accurate documentation, and staying on top of every outstanding item until the case is resolved.