Medicaid Pending Representative

Job Title: Medicaid Pending Representative Location: Long Island, NY Salary: Dependent on Experience Employment Type: Full-Time, In-Person

Description: We are looking for a motivated individual to join our team as a Medicaid Pending Representative. In this full-time role, you will be responsible for ensuring payer sources for Long-Term Care (LTC) patients, with a primary focus on Medicaid pending and private pay patients.

Responsibilities:

• Verify payer sources, including Medicaid pending and private pay patients.
• Facilitate the Medicaid application process, ensuring timely submission and follow-up.
• Coordinate with residents and responsible parties to obtain necessary documents and signatures.
• Review financial documents, including five years of bank statements.
• Manage patient income setup, asset spend-down, and payment processes.
• Ensure completion of pre-admission screenings (PAS) or equivalent for Medicaid patients.
• Request fair hearings for denied cases and conduct weekly utilization reviews (UR).
• Maintain consistent communication with responsible parties regarding asset balances.

Qualifications:

• High School Diploma
• Detail-oriented
• Strong work ethic and team player
• Strong organizational, multi-tasking, and prioritization skills

To Apply: Please email your resume to [email protected].

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