Medicaid specialist assistant Lake County

Allurehcs; Illinois; On-site; USD 40,000 - 50,000; Part time

Job summary

Allurehcs is looking for a Part-Time Illinois Medicaid Long-Term Care Specialist to manage Medicaid applications and cases. The position requires proven experience in handling long-term care Medicaid from application to approval. Candidates should have direct experience with Illinois Medicaid systems, strong communication skills, and a detail-oriented mindset. Compensation ranges from $40,000 to $50,000 annually, based on verified experience. This role offers a collaborative team environment and expects adherence to strict filing deadlines.

Qualifications

• Must have direct experience managing Long-Term Care Medicaid cases.
• Experience working with Medicaid caseworkers.
• Ability to prepare and manage appeals and administrative hearings.

Responsibilities

• File and manage LTC Medicaid applications.
• Monitor eligibility and case progress.
• Prepare documentation for OIG cases and appeals.

Skills

Verifiable Medicaid case management

Strong communication skills

Critical thinking

Attention to detail

Adaptability to policy changes

Tools

PointClickCare software

ABE system

MEDI system

Job description

Part-Time Illinois Medicaid Long-Term Care Specialist (30 Hours/Week)

Verified Medicaid Case Experience Required – Illinois Experience Strongly Preferred

We are seeking a highly experienced Medicaid professional with direct, verifiable, hands‑on experience managing Long-Term Care Medicaid cases from application through approval, appeals, and reopening denied cases.

This is NOT an entry-level position.

General Medicaid knowledge alone is NOT sufficient.

Out-of-state Medicaid experience will be reviewed; however, Illinois Medicaid experience is strongly preferred, as each state operates independently with different systems, policies, and procedural requirements.

MANDATORY QUALIFICATIONS – DO NOT APPLY UNLESS YOU MEET THESE REQUIREMENTS

The candidate must have verifiable, direct experience with:

• Filing Long-Term Care Medicaid applications
• Managing cases from initial filing through approval
• Working directly with Medicaid caseworkers to resolve pending issues
• Handling OIG-related matters
• Preparing and managing appeals, including participation in administrative hearings
• Reopening denied cases and understanding procedural requirements
• Managing strict filing deadlines and timely submission requirements
• Tracking deadlines related to:
  • Backdating coverage
  • Appeals filings
  • Reconsiderations and reopening denied cases

Strong Preference Given To Candidates With Illinois Experience Including:

• Filing applications through the ABE (Application for Benefits Eligibility) system
• Using the MEDI system to verify eligibility and monitor case status
• Working knowledge of the Illinois Medicaid Policy Manual
• Experience with Illinois Long-Term Care billing practices and reimbursement timelines

Illinois experience must be clearly reflected on your resume and will be verified.

Preferred Additional Experience

• Experience using PointClickCare (PCC) software
• Experience working within a long-term care facility environment
• Understanding how Medicaid eligibility impacts facility billing cycles

Key Responsibilities

• File and manage LTC Medicaid applications
• Monitor eligibility and case progress
• Track and comply with all deadlines for appeals, backdating, and reopened cases
• Communicate directly with Medicaid caseworkers to secure timely approvals
• Communicate directly with Business Office Managers and Regional Business Office Managers to ensure smooth processing and follow-through of all pending cases
• Prepare documentation for OIG cases and appeals
• Ensure approvals are obtained timely to protect reimbursement

Excellent written and verbal communication skills are required.

Work Environment & Candidate Profile

This role offers excellent guidance and strong team support from management and coworkers. Collaboration is valued, and you will be part of a supportive team environment.

However, the ideal candidate must:

• Be self‑motivated and able to work independently
• Be highly detail‑oriented and deadline‑driven
• Think critically and act quickly
• Work well with others
• Be adaptable and able to accept and tolerate procedural or policy changes
• Maintain professionalism in a fast‑paced, evolving regulatory environment

Position Details

• Part-Time: 30 hours per week
• Compensation based on verified experience
• Independent role within a collaborative team
• Salary $40,000-$50,000 a year pending experience