Medicaid Pending Specialist

We are seeking a detail-oriented and compassionate Medicaid Pending Specialist to join our team. This role is responsible for assisting residents and their families through the Medicaid application and recertification process, ensuring timely and accurate completion of all requirements. The ideal candidate will have strong knowledge of Medicaid policies and procedures in Florida, excellent organizational skills, and a commitment to supporting residents’ financial needs with professionalism and empathy.

Key Responsibilities:

• Guide residents and families through the Medicaid application, eligibility, and recertification process.
• Review financial documentation, verify information, and ensure compliance with state and federal Medicaid requirements.
• Serve as the primary liaison between residents, families, caseworkers, and government agencies.
• Maintain accurate records and documentation for all applications and approvals.
• Monitor deadlines and ensure timely submission of all paperwork to avoid lapses in coverage.
• Educate residents and families on Medicaid programs, requirements, and available resources.
• Collaborate with the business office and admissions team to support financial planning and admissions processes.
• Stay current with changes in Medicaid laws, regulations, and eligibility criteria.

Qualifications:

• High school diploma or equivalent required; Associate’s or Bachelor’s degree in Business, Social Work, or related field preferred.
• Prior experience with Medicaid applications and eligibility processes strongly preferred (SNF or healthcare setting experience a plus).
• Strong knowledge of Florida Medicaid rules and guidelines.
• Excellent communication and interpersonal skills with the ability to explain complex information clearly.
• Strong organizational skills and attention to detail.
• Proficiency in Microsoft Office and comfort with electronic documentation systems.
• Ability to handle sensitive and confidential information with discretion.

Why Join Us?

We are dedicated to providing compassionate care and outstanding service to our residents. As a Medicaid Specialist, you will play a key role in ensuring peace of mind for families while helping residents access the care they need. We offer a supportive team environment, opportunities for professional growth, and the chance to make a meaningful impact every day.