Regional Medicaid Eligibility Expert

PAC; Home (PA); On-site; USD 65,000 - 95,000; Full time

Job summary

PAC is seeking a Regional Medicaid Application Specialist to manage Medicaid applications and annual recertifications across multiple skilled facilities in the region. You will ensure timely submissions and coordinate with residents, families, facility staff, and state agencies.

You will oversee the full application lifecycle, conduct interviews and financial reviews, prepare and submit to state agencies, and respond to RFIs while resolving denials and appeals.

Qualifications

• Bachelor’s degree in Business, Finance, Social Work, or related field preferred.
• 3–5 years managing Medicaid applications in long-term or post-acute care.
• Expert knowledge of state Medicaid long-term care eligibility and related payers.

Responsibilities

• Oversee the Medicaid application lifecycle from initial submission to annual recertification.
• Conduct interviews and financial reviews to collect required documentation.
• Prepare and submit accurate applications to state agencies on time.
• Respond to RFIs, resolve denials/appeals, and support compliance audits.
• Train facility staff on procedures and document requirements.

Skills

Medicaid Eligibility

Application Management

Regulatory Compliance

HIPAA Knowledge

EHR (PointClickCare)

Interviews & Documentation

Regional Travel

Education

Bachelor’s degree in Business/Finance/Social Work

Tools

PointClickCare

EHR Systems

Job description

PAC is seeking a Regional Medicaid Application Specialist to manage Medicaid applications and annual recertifications across multiple skilled facilities in the region. You will ensure timely submissions and coordinate with residents, families, facility staff, and state agencies.

You will oversee the full application lifecycle, conduct interviews and financial reviews, prepare and submit to state agencies, and respond to RFIs while resolving denials and appeals.