Medicaid​/Medicare Services Specialist

Final date to receive applications: 3/13/2026 (8:00 PM EDT)

Pay Grade 13

Salary: $39,284.88 - $58,927.20 Annually

Employment Type:

EXECUTIVE BRANCH | FULL TIME | ELIGIBLE FOR OVERTIME PAY | 18A | 37.5 HR/WK

Location:

275 E Main Street, Frankfort, KY 40621 USA

The agency may authorize the selected candidate to telecommute. The agency may terminate or modify the telecommuting arrangement at any time. The Department for Medicaid Services (DMS) provides health care access for eligible low-income residents of Kentucky including children, families, pregnant women, the aged and the disabled as well as a number of programs and services directed at specific eligibility and medical needs.

DMS strives each day to meet the mission of the Cabinet for Health and Family Services to be a diverse and inclusive organization providing programs, services and supports that protect and promote the health and well-being of all Kentuckians and their communities.

The Department for Medicaid Services, Division of Program Integrity is responsible for guarding Medicaid against fraud, waste and abuse of program benefits by providers and members, and compliance with federal and state rules and regulations. The Medicaid/ Medicare Services Specialist I position offers a wide-range of learning opportunities, including networking as this position will work closely with Providers, Managed Care Organizations, Management, and sister-agencies.

Seeking a motivated person that will work in a high-volume contact center for the Department for Medicaid Services, Provider Enrollment where identifying customers' needs quickly, clarifying information, and researching every issue is required in order to provide resolutions to issues. To be successful, candidates should be professional, polite, and able to deal with difficult and stressful situations, and able to apply state and federal regulations in decision making.

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• Provides specialized assistance to Medicaid providers, staff within the Department for Medicaid Services (DMS), and Medicaid Contractors.
• Responds to providers and Credentialing Agents inquiries on KY DMS Provider Enrollment eligibility, submission documents, and application status, as well as maintenance required on provider file. Collecting information about caller and provider, verifies in different information systems, and enters information into database. Entering information into Customer Relationship Management (CRM) system to assist with call-tracking and quality assurance.
• Provides assistance to providers and government agencies through oral and written response to inquiries.
• Requires the ability to work independently and manage time effectively, as well as to work with difficult issues. Implements policy changes as appropriate.
• Performs research of state and federal statutes and regulations relative to provider enrollment and remains abreast of all changes to state and federal laws.

The Cabinet for Health and Family Services (CHFS) participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in U.S. CHFS will only use E-Verify once you have accepted a job offer and completed the Form I-9. For more information on E-Verify, or if you believe that CHFS has violated its E-Verify responsibilities, please contact Department of Homeland Security (DHS) at  or https://(Use the "Apply for this Job" box below).

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• Education: Graduate of a college or university with a bachelor's degree.
• Experience, Training, or
  
  Skills:
  
  NONE
• Substitute Education for
  
  Experience:
  
  NONE
• Substitute Experience for
  
  Education:
  
  Experience in Medicaid and/or Medicare program administration, health insurance administration/systems, eligibility systems, health care research, health care planning, health care financial management, health care policy development or human service or health care administration, insurance billing and/or claims will substitute for the required college on a year-for-year basis. Current or prior military experience will substitute for the required college on a year-for-year basis.
• Special Requirements (Age, Licensure, Regulation, etc.): NONE

Incumbents working in this job title primarily perform duties in an office setting.

This job has an initial and promotional probationary period of 6 months, except as provided in KRS 18A.111.

If you have questions about this advertisement, please contact Tiffany Keffer fer or .

An Equal Opportunity Employer M/F/D