Medicaid Specialist

Part-Time Remote Medicaid Specialist — Expert Level

Seeking an experienced Medicaid Specialist to provide part-time, remote support with Medicaid eligibility, renewals, member navigation, documentation, advocacy, and case escalation.

We are looking for someone who can work independently and has strong knowledge of Georgia Medicaid and Medicaid waiver programs, preferably ICWP, CCSP, and/or EDWP.

Responsibilities

• Monitor Medicaid eligibility and renewal dates for members.
• Build and maintain a record-tracking system to monitor Medicaid status, renewal dates, documentation, and outstanding items.
• Send timely Medicaid renewal reminders to members/families and appropriate parties.
• Provide direct Medicaid navigation and advocacy support to members and families.
• Assist members and families with understanding Medicaid requirements, notices, forms, deadlines, and next steps.
• Identify Medicaid eligibility issues, gaps, or barriers and follow up appropriately.
• Escalate Medicaid cases to the appropriate channels in accordance with applicable guidelines and policies.
• Upload, process, organize, and track Medicaid forms and documentation on behalf of the agency and associated members.
• Review forms and documentation for completeness and follow up on missing information.
• Research Medicaid policies, manuals, notices, and procedures to answer complex questions.
• Assist agency staff with Medicaid-related questions and problem-solving.
• Maintain accurate and confidential electronic records.
• Identify recurring issues and recommend improvements to Medicaid workflows and tracking processes.

Qualifications

Required:

• 5+ years of direct Medicaid experience.
• Strong knowledge of Medicaid eligibility and renewal processes.
• Experience working directly with Medicaid members and/or families.
• Ability to independently research and interpret Medicaid policies and procedures.
• Strong organizational, documentation, communication, and problem-solving skills.
• Ability to work independently in a remote environment.

Preferred:

• Georgia Medicaid/DCH experience.
• Experience with ICWP, CCSP, EDWP, or other Medicaid waiver programs.
• Experience with GAMMIS or other Medicaid systems.
• Experience with Medicaid case management or provider operations.
• Experience creating and maintaining tracking systems or databases.

Ideal Candidate

The ideal candidate is a Medicaid expert who can independently identify an issue, research the applicable requirements, take appropriate action, document the activity, follow up, and escalate when necessary.

This position requires someone who is knowledgeable, dependable, organized, detail-oriented, resourceful, and comfortable working with minimal supervision.

Position Details

Job Type: Part-Time
Work Location: Remote
Hours: Approximately 15–20 hours per week
Pay: Based on experience and qualifications

Applicants should include their years of Medicaid experience, Medicaid programs they have worked with, Georgia Medicaid experience (if applicable), and desired hourly rate.

Pay: $25.94 - $31.24 per hour

Work Location: Remote