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Aperion Care Corporate

Medicaid Specialist

Career Insights for Eligibility Specialist

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What they do

An Eligibility Specialist provides assistance and information for people who apply for a government benefits program or health care program. Answers questions, assists with an application process, and reviews applications and relevant background information to determine eligibility. May assist eligible applicants with enrolling in a program.

$48,103 / year median in Illinois

+17% projected growth

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Job Description

Medicaid Specialist Job Summary:
We're seeking a detail‑driven Medicaid Specialist to support our skilled nursing facilities (SNFs) by ensuring accurate Medicaid billing, resolving reimbursement issues, and managing complex eligibility cases. This role is ideal for someone who thrives in a fast‑paced environment, understands Medicaid processes deeply, and enjoys collaborating with facility teams to drive strong financial outcomes. Essential Duties Manage and resolve complex Medicaid cases for SNF facilities Track Medicaid applications, approvals, redeterminations, and admit packs. Assist facilities with Medicaid applications, redeterminations, and admit packs. Communicate with residents or families regarding Medicaid documentation or application needs Document payer activity and follow‑up using company‑approved systems Collaborate closely with Business Office Managers on admit packs and pending applications Conduct monthly reviews with the Business Office Manager and Regional Business Office Mangers Prepare account write‑offs when collection efforts are exhausted What You Bring Experience with Medicaid billing, preferably in a skilled nursing or long‑term care environment Strong understanding of Medicaid eligibility, authorization, and claims processes Ability to analyze account discrepancies and resolve complex billing issues Excellent communication skills with facility staff, residents, and families High attention to detail and strong organizational skills Proficiency with billing systems and electronic documentation tools