Medicaid Specialist

Job Description

Balance Life & Work with a New Career Opportunity

Now Hiring
- Medicaid Specialist

The Medicaid Specialist is responsible for supporting multiple Care One centers within a designated region by completing and tracking pending Medicaid applications and redeterminations in order to ensure financial eligibility for the dates of service needed to secure valid Medicaid payer status. The position requires conducting interviews with patients, families, and responsible parties to determine potential Medicaid program eligibility and coordinating with the local Board of Social Services to complete the application process.

Working knowledge of the New Jersey Medicaid application process and associated state regulations, customer service, documentation, client tracking, and reporting are critical components of this role.

• Provide efficient, timely and consumer friendly services to facilitate the Medicaid eligibility application and redetermination process.
• Meet with families/responsible parties and determine and obtain information and documentation needed to complete the Medicaid application.
• Schedule and attend Medicaid application interviews at local Board of Social Services location(s).
• Regularly follow‑up with local Board of Social Services to determine status of cases.
• Monitor and track Medicaid and redetermination applications throughout the eligibility process and collect and maintain accurate Medicaid eligibility determination tracking logs.
• Communicate timely to Center and Manager any potential problem cases or non‑compliance by family/responsible parties.
• Respond to case discontinuation and/or denials by determining the action required which may include appeal, reapplication or acceptance.
• Participate in center meetings as appropriate to facilitate and enhance the Medicaid eligibility determination process.

• Bachelor's degree preferred or equivalent work experience in long‑term care industry revenue cycle management.
• Working knowledge and understanding of New Jersey/Massachusetts Medicaid application process.
• Strong communication, analytic and writing skills.
• Ability to multi‑task, handle multiple priorities and work independently.
• Computer proficiency.
• Customer service skills.
• Dependable transportation for field work.

The Care One mission is to define excellence within the health care community. We are dedicated to maximizing patient outcomes, treating residents, families and colleagues with respect, dignity and compassion. Through a collaborative and consultative approach, we strive to provide a framework of strength and stability for our centers and communities while maintaining the highest standards of care and service for residents, families and our valued employees.

• Comprehensive Healthcare Benefits
  • Multiple Medical Plans
    • Including Pharmacy
    • Including Teladoc
  • Multiple Dental Plans
  • Vision Plan
  • Health Savings Account (eligibility restrictions apply)
  • Flexible Spending Accounts
  • Voluntary Life and AD&D
  • Short‑Term and Long‑Term Disability Plans
  • Hospital Indemnity Insurance
  • Critical Illness Insurance
  • Accident Insurance
  • Whole Life Insurance
  • Medicare Employee Assistance
• Legal Plan
• Commuter Benefits
• 401k Retirement Plan
• Employee Assistance Program (available to all employees)
• Paid Time Off
  • Vacation
  • Sick Plans in accordance with state laws
• Opportunities to advance and grow your career

We are an Equal Opportunity Employer
EEO/AA/M/F/DV