PA Medicaid Operations & Benefits Specialist

Insidepfa; Woburn (MA); Vor Ort; USD 42.000 - 60.000; Vollzeit

Benefits dieser Stelle

Medical coverage

Dental and vision

401(k) retirement plan with company-m

Zusammenfassung

Patient Funding Alternatives (PFA) seeks a State Operations Coverage Specialist to support the Pennsylvania team, assuring services and medications are in-network and resolving coordination of benefits issues to help families obtain necessary care.

The role requires strong problem-solving, meticulous attention to detail, and deep knowledge of Pennsylvania Medicaid and the PA HIPP program, with a collaborative team environment and structured responsibilities.

Qualifikationen

• High school diploma or GED with healthcare-related coursework or training.
• 2+ years in insurance verification, prior authorization, Medicaid or managed care, or pharmacy benefits.

Aufgaben

• Verify services, providers, and medications are in-network for ESI and Medicaid.
• Coordinate benefits issues and obtain prior authorizations as needed.
• Support team meetings and perform other duties as required.

Kenntnisse

Attention to detail

Problem solving

Verbal and written communication

Ausbildung

High school diploma or GED

Healthcare administration coursework

Bachelor’s degree (preferred)

Jobbeschreibung

Patient Funding Alternatives (PFA) seeks a State Operations Coverage Specialist to support the Pennsylvania team, assuring services and medications are in-network and resolving coordination of benefits issues to help families obtain necessary care.

The role requires strong problem-solving, meticulous attention to detail, and deep knowledge of Pennsylvania Medicaid and the PA HIPP program, with a collaborative team environment and structured responsibilities.