Job Description
Job Description
Eden East is seeking a highly motivated and detail-oriented Medicaid Specialist to support our senior care communities in Pennsylvania. This individual will take the lead in tracking, monitoring, and facilitating Medicaid applications, ensuring that residents receive the benefits they are entitled to in a timely manner.
Job Title : Medicaid Specialist
Location : Pennsylvania (Remote, but must reside in PA)
Job Type : Full-Time
This remote role requires residency in Pennsylvania and a deep understanding of Medicaid processes. The ideal candidate must be proactive, organized, and committed to problem-solving while working closely with facility teams, regional leadership, and state agencies.
Key Responsibilities :
Tracking & Monitoring Medicaid Pending Cases
- Participate in monthly MAP calls to stay updated on all Medicaid pending cases.
- Regularly review logs and apples reports to ensure accuracy and completeness.
Case Oversight & Documentation
Ensure appropriate steps are taken and documented for each Medicaid case.Work with Nechama and other resources to track completed Medicaid packets.Evaluation & Identification of Potential Medicaid Cases
Proactively assess new admissions, especially those transitioning from skilled care to Medicaid Pending status.Serve as the point of contact for yellow referrals, ensuring timely follow-up.Escalation & Problem-Solving
Identify stalled applications on the apples report and MAP log and take the lead in addressing them.Escalate concerns to regional leadership if Business Office Managers (BOMs) or other responsible parties fail to take necessary action.Training & Support
Train facility staff on Medicaid procedures to ensure a strong knowledge base.Collaborate with facility administrators to resolve roadblocks related to Medicaid applications and required documentation.Assistance in Submissions (If Needed)
While not a core function, assist in Medicaid submissions if warranted.Qualifications :
Prior experience in Medicaid eligibility, billing, or healthcare financial services preferred.In-depth knowledge of Pennsylvania Medicaid regulations and processes.Strong organizational, analytical, and problem-solving skills.Excellent communication and interpersonal abilities for working with families, residents, and agencies.Ability to manage multiple tasks and meet deadlines efficiently.Proficiency in Microsoft Office and Medicaid application software.Why Join Us?
Competitive salary and benefits packageRemote work with flexibility (must reside in Pennsylvania)Opportunity to make a direct impact on residents' access to careProfessional development and ongoing trainingA supportive and mission-driven team environmentIf you are passionate about Medicaid processes and want to help seniors access essential care, apply today and be a part of the Eden East team!
INDHAMP
