Medicaid Specialist

We are seeking a dedicated and detail-oriented Medicaid Specialist (Illinois) to join our healthcare support team in Illinois. In this vital role, The Medicaid Specialist is responsible for identifying, resolving, and preventing Medicaid eligibility issues that impact residents’ access to services or hinder reimbursement. This role ensures timely coordination of Medicaid redetermination, collaborates with local eligibility offices, and supports residents through complex eligibility processes. The position is required for field visits to local Medicaid offices, when in-person resolution is more effective.

Details:

• This is a Full-Time Position - 40 weekly hours are required, NOT optional.
• Travel will be required in and around Perry County, Illinois. Mileage/travel reimbursement will be established once the position is filled.
• Daily Hours: 8am - 5pm

Duties

• Investigate and resolve Medicaid eligibility barriers that prevent members from accessing services or disrupt reimbursement workflows.
• Conduct eligibility verification using state systems and health insurance databases.
• Communicate with local eligibility workers to clarify case status and resolve pending or denied actions.
• Oversee and coordinate redetermination submissions.
• Track redetermination cycles and proactively engage resident’s/resident’s RP
• Contact resident’s/Responsible Party to gather required information and explain eligibility requirements.
• Build relationships with local county eligibility offices.
• Maintain accurate, audit-ready documentation.
• Conduct in-person visits to local county offices when necessary.
• Track and report eligibility trends and case outcomes.
• Driving will be required to local county offices.
• Maintain confidentiality, HIPAA compliance, and knowledge of mandated reporting requirements.
• Performs other duties as assigned.

Qualifications

• Strong knowledge of Illinois Medicaid eligibility and public benefit programs
• Knowledge of Illinois Medicaid eligibility rules and redetermination processes.
• Experience in working with electronic healthcare systems, and state eligibility systems. (PCC preferred)
• Familiar with Microsoft Word and Excel programs.
• Strong analytical, organizational and communication skills.
• Strong communication skills.
• Experience in Managed Medical health plans, county eligibility office

Join us in delivering compassionate healthcare support that transforms lives! This role is essential for ensuring equitable access to vital services while fostering a supportive environment for both clients and team members. We are committed to empowering our staff through ongoing training, professional growth opportunities, and a vibrant workplace culture dedicated to excellence.

Pay: $22.00 - $25.00 per hour

Expected hours: 40.0 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid sick time
• Paid time off
• Pet insurance
• Vision insurance

Work Location: In person

Salary : $22 - $25