Medicaid specialist assistant Knox

Part-Time Illinois Medicaid Long-Term Care Specialist (30 Hours/Week)
Verified Medicaid Case Experience Required – Illinois Experience Strongly Preferred

We are seeking a highly experienced Medicaid professional with direct, verifiable, hands‑on experience managing Long-Term Care Medicaid cases from application through approval, appeals, and reopening denied cases.

This is NOT an entry-level position.

General Medicaid knowledge alone is NOT sufficient.

Out-of-state Medicaid experience will be reviewed; however,
Illinois Medicaid experience is strongly preferred
, as each state operates independently with different systems, policies, and procedural requirements.

The candidate must have verifiable, direct experience with:

• Filing Long-Term Care Medicaid applications
• Managing cases from initial filing through approval
• Working directly with Medicaid caseworkers to resolve pending issues
• Handling OIG-related matters
• Preparing and managing appeals, including participation in administrative hearings
• Reopening denied cases and understanding procedural requirements
• Managing strict filing deadlines and timely submission requirements
• Tracking deadlines related to:
  • Backdating coverage
  • Appeals filings
  • Reconsiderations and reopening denied cases

• Filing applications through the ABE (Application for Benefits Eligibility) system
• Using the MEDI system to verify eligibility and monitor case status
• Working knowledge of the Illinois Medicaid Policy Manual
• Experience with Illinois Long-Term Care billing practices and reimbursement timelines

Illinois experience must be clearly reflected on your resume and will be verified.

• Experience using Point Click Care  (PCC) software
• Experience working within a long-term care facility environment
• Understanding how Medicaid eligibility impacts facility billing cycles

• File and manage LTC Medicaid applications
• Monitor eligibility and case progress
• Track and comply with all deadlines for appeals, backdating, and reopened cases
• Communicate directly with Medicaid caseworkers to secure timely approvals
• Communicate directly with Business Office Managers and Regional Business Office Managers to ensure smooth processing and follow-through of all pending cases
• Prepare documentation for OIG cases and appeals
• Ensure approvals are obtained timely to protect reimbursement

Excellent written and verbal communication skills are required.

This role offers
excellent guidance and strong team support from management and coworkers. Collaboration is valued, and you will be part of a supportive team environment.

However, the ideal candidate must:

• Be self‑motivated and able to work independently
• Be highly detail‑oriented and deadline‑driven
• Think critically and act quickly
• Work well with others
• Be adaptable and able to accept and tolerate procedural or policy changes
• Maintain professionalism in a fast‑paced, evolving regulatory environment

• Part-Time: 30 hours per week
• Compensation based on verified experience
• Independent role within a collaborative team
• Salary $40,000-$50,000 a year pending experience