Medicaid Specialist Skilled Nursing

Sweetwater Care; Town of Montana (WI); On-site; USD 45,000 - 70,000; Full time

Job summary

Sweetwater Care is seeking a full-time Medicaid Pending Specialist to assist in completing Medicaid applications, conversions, and reviews for facilities in Montana.

Responsibilities include handling pending applications, processing Montana forms, meeting residents, tracking case progress, and communicating resident liability. Travel to facilities and government offices is frequent to ensure timely approvals and reporting.

Qualifications

• Strong knowledge of Medicaid applications and requirements.
• Ability to organize complex forms and deadlines.
• Clear written and verbal communication skills.

Responsibilities

• Manage pending Medicaid applications and redeterminations to ensure financial eligibility.
• Process Montana state-required forms and coordinate with facilities' business offices.
• Meet with residents and families to discuss liability payments and policies.
• Monitor progress of pending cases and document updates.
• Respond to denials and assist with appeals or reapplication as needed.
• Prepare reports and attend Medicaid Pending meetings with the regional team.

Skills

Medicaid application process

Organizational skills

Verbal and written communication

Attention to detail

Job description

Are you a Nursing Home Medicaid EXPERT?

Sweetwater Care is currently seeking a full time Medicaid Pending Specialist to assist in the completion of Medicaid applications, conversions, and reviews in various facilities in Montana.

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 Montana 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
• Frequent travel to facilities and various governmental offices