Medicaid Pending Specialist
PACS · Salt Lake City, UT · 1 mo ago
On-siteOTHRFull-time
We need to output HTML fragment with sections only if content present. Use for headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We need to decide which sections have content.
From job description: There's a description paragraph: "This person will spend most of their time developing a Medicaid pending process..." That's about the role. So we can have
for headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We need to decide which sections have content.
From job description: There's a description paragraph: "This person will spend most of their time developing a Medicaid pending process..." That's about the role. So we can have About the role
with paragraphs.
Key Responsibilities list: bullet list.
Qualifications: list of qualifications.
There is also "The Candidate" paragraph describing ideal candidate; could be part of Qualifications or maybe a separate "Skills"? But we have Skills section possible. The ideal candidate paragraph includes traits: hard-working, detail oriented, team-orientated, service-minded, proactive, etc. Could be placed under Skills or maybe under Qualifications. Since we have Qualifications already, we could add a Skills section for those soft skills. However we need to avoid thin sections. Could combine candidate description into Qualifications as extra bullet? But better to have a Skills section for those traits.
Benefits: there is a benefits paragraph describing health coverage, PTO, financial wellness, retirement, EAP. So we can have Benefits section.
Pay and Schedule: not mentioned, so omit.
We must not repeat job title as heading. No Job ID.
We must remove boilerplate: EEO statement etc. The last paragraph about diversity is boilerplate EEO; we should remove it. Also "Join PACS: Elevate Healthcare with Us!" etc is promotional but maybe considered part of About the role? It's about company mission; could be included in About the role? It's not boilerplate but it's generic marketing. The instruction: remove cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, and application instructions. The promotional mission statement might be considered not boilerplate but could be kept as part of About the role? It's not duplicated. It's okay to keep as part of About the role? It's not about the role but about company. Might be considered filler but not prohibited. However we should preserve substantive information; it's not essential but could be kept. Safer to keep it as part of About the role? Might be considered fluff. But we can include it as part of About the role if we want. However we should avoid filler like "commensurate with experience". This is not that.
Thus sections: About the role (description + company mission), Responsibilities (list), Qualifications (list), Skills (ideal candidate traits), Benefits (list). Ensure we use - for lists.
We need to preserve all substantive information: include details like Florida Medicaid, asset limits, etc.
Let's extract About the role content: The first paragraph: "This person will spend most of their time developing a Medicaid pending process, tracking Medicaid pending aging’s. This role will include educating and training the office managers on Medicaid pending best practices to ensure positive outcomes with Bad Debt, DSO and Cash Collections. The Medicaid Pending Resource will conduct weekly Medicaid pending aging reviews to look for patterns and trends to see where training is needed. Will be well-versed in all aspects of Florida Medicaid including, Medicaid applications, asset limits, and local Medicaid office case workers."
Then later there is "Join PACS: Elevate Healthcare with Us! PACS is elevating healthcare by revolutionizing our approach to leadership and quality care. Guided by our core values of love, excellence, trust, accountability, mutual respect, and commitment, we strive to foster a culture of compassionate care within our teams and the communities we serve. As we grow rapidly, exciting opportunities await you to engage in impactful projects and contribute valuable insights to stakeholders nationwide. If you're ready to make a difference and embrace our mission of creating real change, we invite you to join us at PACS. Together, let’s shape the future of healthcare! Join Our Team and Thrive! At PACS, we believe our employees are our greatest asset. That’s why we offer an exceptional benefits package designed to enhance your well-being and support your lifestyle."
That's promotional; we could include it in About the role as extra paragraphs.
Now Responsibilities list: bullet points from "Key Responsibilities". Let's list each line:
- Track and manage a caseload of Medicaid Pending residents from admission through Medicaid approval
- Complete, submit, and follow up on Medicaid applications with state/county eligibility offices
- Coordinate with residents, families, and responsible parties to gather required documentation (financial, medical, legal)
- Communicate regularly with facility Business Office Managers, Admissions, and Social Services to resolve outstanding eligibility issues
- Monitor and report on aging pending accounts; escalate stalled cases to reduce time-to-approval
- Maintain accurate, up-to-date records in the resident management/billing system (e.g., PointClickCare, Matrixcare)
- Ensure compliance with state Medicaid regulations and PACS policies
- Partner with Medicaid caseworkers and eligibility agencies to expedite determinations
- Assist in spend-down documentation, resource assessments, and appeals when applications are denied
- Proficient in Excel and PCC
Note: "Proficient in Excel and PCC" maybe a qualification but it's under responsibilities; we keep it there.
Qualifications list: from "Qualifications" paragraph lines:
- The Medicaid Pending Resource should have a minimum of four years’ experience and proven success in a Skilled Nursing Facility.
- Effective in business office operations
- Working knowledge of Medicaid eligibility requirements (state-specific knowledge a plus)
- Proven positive outcomes in cash collections, bad debt and DSO
- Experience with EHR/billing systems (PointClickCare preferred)
- Strong organizational skills with ability to manage a high-volume caseload
- Ability to multi-task in different programs and be able to assist multiple facilities at once
- Excellent communication skills for interfacing with families, state agencies, and internal stakeholders
- High school diploma required; associate's or bachelor's degree preferred
- Must be flexible and willing to travel to different facilities located in Florida
- Leadership abilities that promote a positive work environment while teaching and training
- Effective time management, organizational skills, and detail-oriented
- Prior experience in a multi-facility or corporate long-term care environment
- Familiarity with Medicaid spend-down, trusts, and asset transfer rules
- 2+ years of experience with Medicaid eligibility, long-term care billing, or skilled nursing preferred
Note some duplicates: organizational skills appears twice; we can keep both but maybe combine. We'll keep as listed.
Skills section: from "The Candidate" paragraph:
- The ideal candidate will be hard-working, detail oriented, team-orientated, service-minded and proactive.
- Someone who takes pride in providing a high-quality work product and seeks continuous improvement.
We could make bullet list.
Benefits list: from benefits paragraph:
- Health Coverage: Enjoy medical, dental, and vision plans to keep you and your family healthy.
- PTO and Vacation: Benefit from generous paid time off and holidays to relax and recharge.
- Financial Wellness: Take advantage of Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) to manage your healthcare expenses effectively.
- Retirement Planning: Secure your future with our 401(k) plan, complete with company contributions to help you build your retirement savings.
- Support When You Need It: Our Employee Assistance Plan (EAP) provides confidential support for personal and professional challenges.
We'll make list.
Now produce HTML fragment: start with maybe but not required. Just output headings and content.
We must not include or . Just fragment.
We'll output:
About the role
This person will spend most of their time developing a Medicaid pending process, tracking Medicaid pending aging’s. This role will include educating and training the office managers on Medicaid pending best practices to ensure positive outcomes with Bad Debt, DSO and Cash Collections. The Medicaid Pending Resource will conduct weekly Medicaid pending aging reviews to look for patterns and trends to see where training is needed. Will be well-versed in all aspects of Florida Medicaid including, Medicaid applications, asset limits, and local Medicaid office case workers.
Join PACS: Elevate Healthcare with Us! PACS is elevating healthcare by revolutionizing our approach to leadership and quality care. Guided by our core values of love, excellence, trust, accountability, mutual respect, and commitment, we strive to foster a culture of compassionate care within our teams and the communities we serve. As we grow rapidly, exciting opportunities await you to engage in impactful projects and contribute valuable insights to stakeholders nationwide. If you're ready to make a difference and embrace our mission of creating real change, we invite you to join us at PACS. Together, let’s shape the future of healthcare! Join Our Team and Thrive! At PACS, we believe our employees are our greatest asset. That’s why we offer an exceptional benefits package designed to enhance your well-being and support your lifestyle.
Responsibilities
- Track and manage a caseload of Medicaid Pending residents from admission through Medicaid approval
- Complete, submit, and follow up on Medicaid applications with state/county eligibility offices
- Coordinate with residents, families, and responsible parties to gather required documentation (financial, medical, legal)
- Communicate regularly with facility Business Office Managers, Admissions, and Social Services to resolve outstanding eligibility issues
- Monitor and report on aging pending accounts; escalate stalled cases to reduce time-to-approval
- Maintain accurate, up-to-date records in the resident management/billing system (e.g., PointClickCare, Matrixcare)
- Ensure compliance with state Medicaid regulations and PACS policies
- Partner with Medicaid caseworkers and eligibility agencies to expedite determinations
- Assist in spend-down documentation, resource assessments, and appeals when applications are denied
- Proficient in Excel and PCC
Qualifications
- The Medicaid Pending Resource should have a minimum of four years’ experience and proven success in a Skilled Nursing Facility.
- Effective in business office operations
- Working knowledge of Medicaid eligibility requirements (state-specific knowledge a plus)
- Proven positive outcomes in cash collections, bad debt and DSO
- Experience with EHR/billing systems (PointClickCare preferred)
- Strong organizational skills with ability to manage a high-volume caseload
- Ability to multi-task in different programs and be able to assist multiple facilities at once
- Excellent communication skills for interfacing with families, state agencies, and internal stakeholders
- High school diploma required; associate's or bachelor's degree preferred
- Must be flexible and willing to travel to different facilities located in Florida
- Leadership abilities that promote a positive work environment while teaching and training
- Effective time management, organizational skills, and detail-oriented
- Prior experience in a multi-facility or corporate long-term care environment
- Familiarity with Medicaid spend-down, trusts, and asset transfer rules
- 2+ years of experience with Medicaid eligibility, long-term care billing, or skilled nursing preferred
Skills
- Hard-working, detail oriented, team-orientated, service-minded and proactive
- Takes pride in providing a high-quality work product and seeks continuous improvement
Benefits
- Health Coverage: Enjoy medical, dental, and vision plans to keep you and your family healthy.
- PTO and Vacation: Benefit from generous paid time off and holidays to relax and recharge.
- Financial Wellness: Take advantage of Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) to manage your healthcare expenses effectively.
- Retirement Planning: Secure your future with our 401(k) plan, complete with company contributions to help you build your retirement savings.
- Support When
About the role
This person will spend most of their time developing a Medicaid pending process, tracking Medicaid pending aging’s. This role will include educating and training the office managers on Medicaid pending best practices to ensure positive outcomes with Bad Debt, DSO and Cash Collections. The Medicaid Pending Resource will conduct weekly Medicaid pending aging reviews to look for patterns and trends to see where training is needed. Will be well-versed in all aspects of Florida Medicaid including, Medicaid applications, asset limits, and local Medicaid office case workers.
Join PACS: Elevate Healthcare with Us! PACS is elevating healthcare by revolutionizing our approach to leadership and quality care. Guided by our core values of love, excellence, trust, accountability, mutual respect, and commitment, we strive to foster a culture of compassionate care within our teams and the communities we serve. As we grow rapidly, exciting opportunities await you to engage in impactful projects and contribute valuable insights to stakeholders nationwide. If you're ready to make a difference and embrace our mission of creating real change, we invite you to join us at PACS. Together, let’s shape the future of healthcare! Join Our Team and Thrive! At PACS, we believe our employees are our greatest asset. That’s why we offer an exceptional benefits package designed to enhance your well-being and support your lifestyle.
Responsibilities
- Track and manage a caseload of Medicaid Pending residents from admission through Medicaid approval
- Complete, submit, and follow up on Medicaid applications with state/county eligibility offices
- Coordinate with residents, families, and responsible parties to gather required documentation (financial, medical, legal)
- Communicate regularly with facility Business Office Managers, Admissions, and Social Services to resolve outstanding eligibility issues
- Monitor and report on aging pending accounts; escalate stalled cases to reduce time-to-approval
- Maintain accurate, up-to-date records in the resident management/billing system (e.g., PointClickCare, Matrixcare)
- Ensure compliance with state Medicaid regulations and PACS policies
- Partner with Medicaid caseworkers and eligibility agencies to expedite determinations
- Assist in spend-down documentation, resource assessments, and appeals when applications are denied
- Proficient in Excel and PCC
Qualifications
- The Medicaid Pending Resource should have a minimum of four years’ experience and proven success in a Skilled Nursing Facility.
- Effective in business office operations
- Working knowledge of Medicaid eligibility requirements (state-specific knowledge a plus)
- Proven positive outcomes in cash collections, bad debt and DSO
- Experience with EHR/billing systems (PointClickCare preferred)
- Strong organizational skills with ability to manage a high-volume caseload
- Ability to multi-task in different programs and be able to assist multiple facilities at once
- Excellent communication skills for interfacing with families, state agencies, and internal stakeholders
- High school diploma required; associate's or bachelor's degree preferred
- Must be flexible and willing to travel to different facilities located in Florida
- Leadership abilities that promote a positive work environment while teaching and training
- Effective time management, organizational skills, and detail-oriented
- Prior experience in a multi-facility or corporate long-term care environment
- Familiarity with Medicaid spend-down, trusts, and asset transfer rules
- 2+ years of experience with Medicaid eligibility, long-term care billing, or skilled nursing preferred
Skills
- Hard-working, detail oriented, team-orientated, service-minded and proactive
- Takes pride in providing a high-quality work product and seeks continuous improvement
Benefits
- Health Coverage: Enjoy medical, dental, and vision plans to keep you and your family healthy.
- PTO and Vacation: Benefit from generous paid time off and holidays to relax and recharge.
- Financial Wellness: Take advantage of Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) to manage your healthcare expenses effectively.
- Retirement Planning: Secure your future with our 401(k) plan, complete with company contributions to help you build your retirement savings.
- Support When