What are the responsibilities and job description for the Corporate Operations - Medicaid Specialist position at Pioneer Health Care Management Inc?
Job Title: Medicaid Specialist
Job Summary:
We are seeking a detail-oriented and knowledgeable Medicaid Specialist to join our team. This role is responsible for assisting individuals in the Medicaid application and renewal process, ensuring compliance with federal and state regulations, and maintaining accurate documentation. The ideal candidate will have experience in healthcare billing, Medicaid eligibility requirements, and strong communication skills to effectively interact with patients, families, and government agencies.
Key Responsibilities:
- Assist patients and families with Medicaid applications, renewals, and verifications.
- Review and process Medicaid eligibility documentation to ensure compliance with state and federal guidelines.
- Coordinate with government agencies, healthcare providers, and internal teams to resolve application issues and secure approvals.
- Maintain up-to-date knowledge of Medicaid policies, regulations, and procedural changes.
- Monitor Medicaid status for patients and proactively address pending applications or renewals.
- Ensure proper documentation and record-keeping of all Medicaid-related interactions.
- Educate patients and families about Medicaid benefits, requirements, and available resources.
- Work closely with billing and finance departments to reconcile Medicaid claims and payments.
- Handle confidential patient information in accordance with HIPAA and organizational policies.
Qualifications:
- High school diploma or equivalent (Associate’s or Bachelor’s degree preferred).
- Previous experience in Medicaid eligibility, healthcare billing, or a related field.
- Knowledge of Medicaid regulations, application processes, and documentation requirements.
- Strong organizational skills and attention to detail.
- Excellent verbal and written communication skills.
- Proficiency in Microsoft Office Suite and Medicaid processing systems.
- Ability to work independently and collaboratively in a fast-paced environment.
Preferred Qualifications:
- Experience working in a healthcare, social services, or long-term care setting.
- Bilingual abilities are a plus.
Work Environment:
- This position may require interactions with patients, families, government agencies, and internal staff.
- Office-based setting with potential for remote work depending on organizational needs.
If you are passionate about helping individuals navigate Medicaid and ensuring they receive the healthcare coverage they need, we encourage you to apply.
