Medicaid Specialist

Position Summary

Medicaid Specialist will be responsible for working on Medicaid Pending Applications and Renewals to ensure financial eligibility for the dates of service needed to secure valid Medicaid payer status for the facility.

• Medical Assistance Applications & Renewals including processing of all appropriate forms and submitting to the State per GA Medicaid policy.
• Meet with families and responsible parties as per GA Medicaid policy to obtain necessary paperwork.
• Monitor and document progress of pending Medicaid cases and renewals in the EMR Accounts Receivable Collection module per the facility’s policy.
• Follow up with the county Medicaid office on status of cases per GA Medicaid policy & procedures.
• Communicate timely to BOM, Administrator, and RFA of any potential problem cases or noncompliance by families or responsible parties per GA Medicaid policy & procedures.
• Participate in Medicaid Pending AR Meetings to review all pending cases as scheduled.
• Upload appropriate documentation to the facility’s EMR Miscellaneous Tab and to the GA Medicaid portal.
• Respond to case discontinuation and/or denial by determining the appropriate action, which may include appeal, reapplication, or acceptance.
• Perform other duties or projects as assigned by the Business Office Manager.

Strong organizational skills with a good sense of detail. Good verbal and written communication skills.

Medicaid and skilled nursing facility background preferred.

High School Diploma or GED required.

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