Government Programs & Reimbursement Coordinator

Government Programs & Reimbursement Coordinator

CommonSail Investment Group

Position Summary:

The Government Programs & Reimbursement Coordinator is responsible for the coordination, research, application processing, compliance tracking, and billing oversight for Medicaid waiver participation across StoryPoint Group assisted living and memory care communities and CorsoCare Personal Care in multiple states.

This role serves as the internal subject matter resource for Home and Community-Based Services (HCBS) waivers, state-specific Medicaid programs, VA, GUIDE program and other government payor type programs. The Coordinator ensures timely enrollment, accurate documentation, regulatory compliance, and proper billing processes to support operational success and revenue integrity.

This position works cross-functionally with Compliance, Operations, Clinical, Finance, and Revenue teams to support sustainable waiver participation aligned with our Safety First commitment and regulatory excellence standards.

Required Experience for Government Programs & Reimbursement Coordinator:

• Education: Bachelor’s degree preferred (Healthcare Administration, Business, Public Health, or related field).
• Experience: 2–5 years experience in healthcare administration, Medicaid programs, senior living, or long-term care.
• Program Knowledge: Familiarity with Medicaid waiver or managed care programs preferred.
• Regulatory Knowledge: Multi-state regulatory exposure preferred.
• Billing Knowledge: Experience with healthcare billing processes strongly preferred.

Primary Responsibilities for Government Programs & Reimbursement Coordinator:

1. Research & Program Tracking

• Research state-specific Medicaid waiver requirements and program updates.
• Monitor changes to HCBS regulations and state waiver amendments.
• Maintain a multi-state waiver tracking matrix including:
  • Enrollment status
  • Renewal deadlines
  • Required documentation
  • Managed care participation
• Prepare summaries of regulatory updates for leadership review.

2. Application & Enrollment Coordination

• Coordinate and prepare Medicaid waiver provider enrollment applications.
• Collect required documentation from communities and corporate departments.
• Track submission timelines and follow up with state agencies and MCOs as applicable.
• Maintain organized records of:
  • Provider enrollments
  • Credentialing approvals
  • Attestations
  • Site readiness inspections
• Serve as point of contact for state Medicaid agencies during application processes.

3. Compliance Monitoring

• Maintain waiver compliance checklists for participating communities.
• Track required documentation such as:
  • Service plans
  • Eligibility verification
  • Staffing requirements
  • HCBS setting compliance attestations
• Support internal audits and assist with corrective action tracking.
• Coordinate documentation for state audits or desk reviews.
• Maintain waiver policies and procedures library.

4. Billing & Revenue Coordination

• Collaborate with Revenue Cycle and Finance teams to:
  • Ensure waiver billing processes are properly implemented.
  • Confirm documentation supports billed services.
  • Track denials or payment discrepancies.
• Maintain waiver billing logs and reconciliation reports.
• Assist with investigation of billing issues or recoupment concerns.
• Develop tracking tools to monitor billing accuracy and timeliness.

5. Operational Support & Training

• Support communities in onboarding waiver residents by:
  • Providing documentation guidance.
  • Reviewing required forms.
  • Clarifying service requirements.
• Assist in development of waiver training materials for:
  • Executive Directors
  • Wellness Directors
  • Property Administrators
• Provide ongoing support for waiver-related questions from field teams.

6. Reporting & Communication

• Maintain centralized dashboards.
• Prepare monthly status reports on:
  • Enrollment activity
  • Compliance metrics
  • Billing trends
• Escalate risks or compliance concerns to leadership.
• Participate in cross-functional meetings related to Medicaid and reimbursement.

Accountability Metrics:

• Timely and accurate submission of waiver applications.
• Zero missed enrollment or renewal deadlines.
• Billing accuracy rate in collaboration with Revenue Cycle.
• Audit documentation readiness.
• Reduction in waiver-related denials or recoupments.
• Accurate tracking of waiver participation across all states.

Skills for Success:

• Building solid cross-functional relationships aligned with the organization's 1440 Care Standards.
• Strong organizational skills
• Regulatory research capability
• Attention to detail
• Project coordination
• Financial and billing awareness
• Cross-functional communication
• Deadline management

Travel: Minimal to moderate travel as needed for state inspections or operational support.

General Working Conditions: This position involves frequent standing, sitting, and walking. The employee will regularly communicate effectively, handle keyboards, telephones, and documentation. Occasional lifting of up to 25 pounds may be required. Occasional travel to community locations is expected. The work environment involves moderate noise levels and requires positive interaction with colleagues and residents.

Equal Opportunity Employer

StoryPoint Group is committed to fostering a culture of excellence, safety, and continuous improvement in all areas of resident care.

#CSALL