Medicaid Support Specialist

Overview

The Medicaid Support Specialist provides expertise and assistance to field staff in Medicaid enrollment and eligibility processes. They communicate policy changes, escalate issues to leadership, and help ensure proper payer reimbursements. The role coordinates with operations, utilization management, and claims to prevent unnecessary costs. Responsibilities also include supporting internal process improvements and maintaining compliance with Medicaid billing guidelines. This role plays a key part in optimizing Medicaid enrollment outcomes and operational efficiency.

Responsibilities

• Support field staff on Medicaid enrollment and eligibility matters

• Communicate Medicaid policy updates and organizational changes

• Escalate issues to departmental leadership as needed

• Coordinate across departments to ensure accurate payer reimbursement

• Assist in QA audits and process improvements related to Medicaid billing

Qualifications

EDUCATION

• Bachelor’s degree preferred or equivalent years of work experience

EXPERIENCE

• 1-2 years of experience with Medicaid/Private insurance billing/claims or enrollments

• 1-2 years of experience with analyzing data, creation of reports, and converting for meaningful use for internal and external clients

• 1 year of Customer Service experience preferred

LICENSES/CERTIFICATIONS

• None required