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EDEN EAST is a portfolio of skilled nursing on the East Coast. As an industry-leading provider of post-acute care, Eden has been dedicated to changing the way healthcare is delivered. We are passionate about elevating and enhancing our employees as they are the core of the care and love we aim for, cultivating a family-like environment to ensure our residents are treated like family.
Edenbrook Yeadon is seeking a highly motivated and detail-oriented Medicaid Specialist to support our senior care communities. This individual will take the lead in tracking, monitoring, and facilitating Medicaid applications, ensuring that residents receive the benefits they are entitled to in a timely manner.
Position: Medicaid Specialist
The ideal candidate must be proactive, organized, and committed to problem-solving while working closely with facility teams, regional leadership, and state agencies.
Key Responsibilities:
- Tracking & Monitoring Medicaid Pending Cases
- Participate in monthly MAP calls to stay updated on all Medicaid pending cases.
- Regularly review logs and apples reports to ensure accuracy and completeness.
Case Oversight & Documentation
- Ensure appropriate steps are taken and documented for each Medicaid case.
- Work with Nechama and other resources to track completed Medicaid packets.
Evaluation & Identification of Potential Medicaid Cases
- Proactively assess new admissions, especially those transitioning from skilled care to Medicaid Pending status.
- Serve as the point of contact for yellow referrals, ensuring timely follow-up.
Escalation & Problem-Solving
- Identify stalled applications on the apples report and MAP log and take the lead in addressing them.
- Escalate concerns to regional leadership if Business Office Managers (BOMs) or other responsible parties fail to take necessary action.
Training & Support
- Train facility staff on Medicaid procedures to ensure a strong knowledge base.
- Collaborate with facility administrators to resolve roadblocks related to Medicaid applications and required documentation.
Assistance in Submissions (If Needed)
- While not a core function, assist in Medicaid submissions if warranted.
Qualifications:
- Prior experience in Medicaid eligibility, billing, or healthcare financial services preferred.
- In-depth knowledge of Pennsylvania Medicaid regulations and processes.
- Strong organizational, analytical, and problem-solving skills.
- Excellent communication and interpersonal abilities for working with families, residents, and agencies.
- Ability to manage multiple tasks and meet deadlines efficiently.
- Proficiency in Microsoft Office and Medicaid application software.
Why Join Edenbrook Yeadon?
- Competitive salary and benefits package
- Opportunity to make a direct impact on residents' access to care
- Professional development and ongoing training
- A supportive and mission-driven team environment
If you are passionate about Medicaid processes and want to help seniors access essential care, apply today and be a part of the team!
