Medicaid Provider Support Specialist

Brief Description

Why Join Harbor Care?

The Medicaid Provider Support Specialist at Harbor Care is a career where you can make a meaningful impact every day. This role plays a vital part in advancing Harbor Care's mission and vision by supporting Recovery Community Organizations (RCOs) in understanding and complying with New Hampshire Medicaid provider requirements.

Key Responsibilities

• Provide technical assistance and consultation to Recovery Community Organizations (RCOs) on Medicaid provider enrollment, billing practices, documentation requirements, regulatory compliance, and operational best practices.
• Develop and deliver in-person and virtual trainings on Medicaid regulations, reimbursement processes, provider responsibilities, documentation standards, and compliance requirements.
• Conduct onsite and remote provider assessments to evaluate compliance with Medicaid regulations, licensing requirements, and NH He-W 513 standards, while identifying opportunities for quality and operational improvement.
• Interpret and communicate federal, state, and Medicaid regulations, translating complex requirements into practical guidance, policies, workflows, and procedures for provider organizations.
• Support providers in audit readiness, documentation management, corrective action planning, and implementation of compliance-focused practices.
• Review medical records, treatment plans, clinical documentation, and billing files to ensure accuracy, medical necessity, completeness, and compliance with Medicaid and HIPAA requirements.
• Maintain accurate records and reporting of technical assistance activities, training participation, and provider interactions while contributing to statewide initiatives, committees, and continuous quality improvement efforts.
• Build positive and professional relationships with clients, staff, and community partners.
• Maintain accurate and timely documentation, records, or reporting requirements.
• Support Harbor Care’s philosophy of care, mission, and organizational values in day-to-day work.

Requirements

• Minimum of three years of experience in Medicaid administration, healthcare compliance, behavioral health, provider relations, quality improvement, healthcare operations, or a related field.
• Minimum of 2 years of direct experience handling Medicaid medical billing, ICD-10/CPT coding, or regulatory compliance auditing.
• Experience providing technical assistance, consultation, education, or organizational capacity-building preferred.
• Experience working with behavioral health providers, peer recovery support programs, nonprofit organizations, or community-based providers strongly preferred.
• Experience interpreting healthcare regulations and translating regulatory requirements into operational guidance preferred.
• A bachelor's degree in Public Health, Healthcare Administration, Human Services, Social Work, Business Administration, Nursing, or a related field strongly preferred.
• A valid driver's license with reliable transportation for statewide travel.
• Regular statewide travel is required to support trainings, provider consultations, meetings, and other program activities.
• Certification or specialized training related to Medicaid, compliance, healthcare quality, project management, or adult education is desirable.
• Knowledge of NH He-W 513, HIPAA, 42 CFR Part 2, and applicable behavioral health regulations strongly preferred.

Physical and Work Environment

• Primarily performs work in a remote office environment with regular use of computers and virtual meeting platforms.
• Frequent use of computers and virtual meeting platforms.
• Travels throughout New Hampshire to conduct provider site visits, trainings, meetings, and conferences.
• Maintains a professional home office with reliable high-speed internet connectivity.
• Frequently presents information to groups and facilitates both virtual and in-person educational sessions.
• May occasionally lift and transport training materials or equipment weighing up to 25 pounds.
• Occasional evening travel or overnight travel may be required based on program needs.

The Ideal Candidate

• Passionate about helping others.
• Adaptable and solution-focused.
• Comfortable working in a fast-paced environment.
• A strong communicator and team player.
• Committed to treating all individuals with dignity and respect.

Summary Benefits

• Medical, dental, and vision insurance.
• Employee-paid life insurance options.
• Generous paid time off and company-paid holidays.
• 401(k) retirement plan with an excellent employer match.
• Employee wellness and support resources.
• Opportunities for professional growth and development.