Impress employers and recruiters.
Choose from hundreds of resume examples.

Target Resume Now

Tailor your resume to this Medicaid Specialist role.

Rezi rewrites your resume against St Camillus Residential Health's job description. Free.

Resume score gauge reading 58 out of 100

Don't guess if your resume is good enough.

See how it scores against the Medicaid Specialist posting at St Camillus Residential Health — free, in seconds.

About the Role

St. Camillus is seeking a Full Time Medicaid Specialist to join their Patient Financial Services Team. This role is crucial for managing resident financial liability and ensuring timely Medicaid application processes.

Responsibilities

Review insurance coverage with families to determine financial liability and/or need for Medicaid.
Determine estimated Net Available Monthly Income (NAMI).
Complete, monitor, and ensure timely submission of Medicaid applications and recertifications.
Maintain knowledge of third-party billing regulations.
Assist with day-to-day billing functions as needed.
Track Medicaid application submission deadlines and status.
Communicate with local DSS office, St. Camillus staff, and residents/family members for timely approval and increased cash flow.
Obtain required documentation from families or financial institutions.
Complete and submit required Medicaid forms (e.g., LDSS 3559s, Nursing Home Account Sheets, PRIs).
Maintain accurate records of member eligibility status, recertification dates, and MLTC provider.
Demonstrate knowledge of general skilled nursing facility payers and billing procedures.
Utilize financial reports to follow Private accounts that may need Medicaid.
Enter approved Medicaid application information into the billing system.
Report Medicaid application issues to PFS Manager, Director of Finance, and VP of Finance.
Provide written referral and backup documentation for Medicaid cases requiring attorney involvement.
Assist with any financial audits initiated by outside agencies (e.g., OMIG, Social Security).
Support department Manager, Director of Finance, and VP of Finance with required tasks.
Ensure employee injury prevention, follow safety rules, and address safety issues with supervisor.
Perform other duties as assigned by supervisor.

Requirements

Must be knowledgeable of the most current Medicaid regulations and the Medicaid application process.
Must be knowledgeable on general skilled nursing facility payers and billing procedures.
Associate’s Degree.
Experience in Medicaid Eligibility and/or Skilled Nursing Facility Medicaid billing.
Strong Microsoft Office experience (Word and Excel).
Strong verbal, written, computer, and leadership skills are required.
Must be a team player and able to build strong relationships with residents and their families.
Must be able to work independently managing multiple projects at once.

Skills

Medicaid regulations
Medicaid application process
Insurance coverage review
Financial liability determination
Net Available Monthly Income (NAMI) estimation
Third-party billing
Billing functions
Microsoft Office (Word, Excel)
Verbal communication
Written communication
Computer skills
Leadership skills
Teamwork
Relationship building
Independent work
Project management

Location

On-site

Work Type

Full Time

Education Level

Associate’s Degree

Benefits

Generous Paid Time Off
Affordable Health/Dental/Vision Plans
Company Funded Life Insurance
Company Funded Health Reimbursement Account
Retirement Plan
On the Centro Bus Line
Free parking
On-site cafeteria

About the Company

St. Camillus is a non-denominational, not-for-profit organization dedicated to caring for life through a broad range of health care services.
Our Vision: To be the provider of choice for compassionate and innovative care.
For more information about St. Camillus and Integrity Home Care Services visit our website at http://www.st-camillus.org

Equal Opportunity

EOE/Affirmative Action Employer