Medicaid Specialist

6 days ago

Philadelphia, Pennsylvania, United States Longterm Healthcare Facility Full time

Nursing and Rehabilitation Center located in the Germantown section of Philadelphia, offering skilled nursing, short-term rehabilitation and long-term care services. Our staff are committed to providing excellent care and services in a friendly, resident-focused, home-like environment.

The MA Specialist works closely with the Admissions Director and Business Office Manager to determine what residents will need for a Medicaid application as well as follow through with the application process through to approval/denial.

Key Responsibilities

  • Prepare, submit, and complete Medicaid applications for all residents.

  • Follow the submission process as directed by management.

  • Collect required documentation from residents or family members to secure Medicaid approval.

  • Contact banks, insurance companies, pension providers, and other institutions for eligibility verification.

  • Maintain close communication with facility Business Office Managers regarding case status, income figures, and other critical details.

  • Track Medicaid pending cases, notes, and documents in Aidace.

  • Meet all application deadlines; request extensions when documentation cannot be collected on time.

  • Appeal denials and attend hearings when appropriate.

  • Escalate cases to management when facing barriers in obtaining information or signatures.

  • Communicate as needed with Medicaid caseworkers.

  • Upon receipt of approvals (e.g., PA 162), review for accuracy including effective date, income, and deductions; scan documents into Aidace and notify the BOM, manager, and CEO.

  • Participate in weekly case review meetings with your manager.

Requirements

  • Strong communication and interpersonal skills; ability to collaborate effectively with residents, families, and facility staff.

  • Problem-solving skills with the ability to think critically and identify solutions when challenges arise.

  • Empathy and a client-focused mindset, ensuring sensitivity to resident and family needs.

  • Detail-oriented with the ability to manage multiple cases and deadlines simultaneously.

  • Proficiency with Aidace or willingness to learn quickly.

We're an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

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