Medicaid Specialist

Position Overview :

We are seeking a detail-oriented and experienced Medicaid Specialist to join our team, supporting two of our Bloomsburg, PA facilities . The ideal candidate will ensure accurate Medicaid billing, eligibility verification, and compliance with state and federal regulations, while collaborating with clinical and administrative teams to maximize reimbursement.

Key Responsibilities :

Prepare, submit, and reconcile Medicaid claims for both facilities.

Verify Medicaid eligibility and benefits for new and existing residents.

Monitor claim status, resolve denials, and follow up with Medicaid agencies as needed.

Ensure compliance with state and federal regulations regarding Medicaid billing and documentation.

Maintain accurate resident records and billing files.

Collaborate with finance, admissions, and clinical teams to ensure timely and accurate billing.

Assist with audits and reporting related to Medicaid reimbursement.

Provide guidance and support to staff on Medicaid-related processes and updates.

Qualifications :

Previous experience in Medicaid billing and reimbursement in a long-term care or healthcare setting.

Strong understanding of state and federal Medicaid regulations.

Excellent attention to detail and organizational skills.

Proficient with electronic health record (EHR) and billing software.

Strong communication skills and ability to work collaboratively with multiple teams.

High school diploma required; Associate’s or Bachelor’s degree in healthcare administration, finance, or related field preferred.

Why Join Us :

Opportunity to work across two facilities in Bloomsburg and make a direct impact on resident care and facility operations.

Supportive and collaborative work environment.

Competitive compensation and benefits package.