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HireCare Services

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.

$54,996 / year median in Rhode Island

+21% projected growth

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Job Description

HireCare Services is partnering with a leading healthcare organization in Rhode Island to recruit an experienced Medicaid Specialist to oversee pending Medicaid cases and ensure timely, consistent follow-up from application through approval. The ideal candidate will have 5-7+ years of Medicaid and/or Business Office Manager (BOM) experience and a strong understanding of Medicaid applications, eligibility, documentation, and case management. This position is ideal for a highly organized, detail-oriented professional who takes ownership of their workload and ensures that no pending Medicaid case is left without proper follow-up. Responsibilities Oversee and manage all pending Medicaid applications and cases Follow up consistently on pending applications, outstanding documentation, and eligibility requirements Monitor each case from application through Medicaid approval Review applications and supporting documentation for accuracy and completeness Identify missing information, outstanding requirements, and potential delays Communicate with residents, families, Medicaid agencies, facilities, and other involved parties Track case status, deadlines, documentation requests, and follow-up activity Maintain accurate and up-to-date Medicaid records and case notes Proactively address issues that may delay Medicaid approval Provide regular updates regarding pending Medicaid cases and outstanding items Coordinate with business office and administrative teams to ensure efficient Medicaid processing Ensure timely and thorough follow-up on all open Medicaid cases Stay current on Medicaid requirements, regulations, and application processes Take full ownership of the Medicaid pipeline and drive cases toward resolution Qualifications 5-7+ years of Medicaid and/or Business Office Manager (BOM) experience required Strong knowledge of Medicaid eligibility, applications, documentation, and processes Experience managing pending Medicaid applications and a high-volume caseload preferred Skilled in tracking applications and following up on outstanding documentation Strong organizational and time-management skills Excellent attention to detail and follow-through Strong written and verbal communication skills Ability to work independently and take ownership of responsibilities Strong problem-solving skills Healthcare, skilled nursing, long-term care, or related experience preferred What We Offer $85,000-$95,000 annual salary Full-time position Supportive and collaborative work environment Opportunity to take ownership of a critical Medicaid operation Professional growth and development opportunities Work alongside an experienced healthcare operations team What We Are Looking For We are looking for an experienced Medicaid Specialist who is highly organized, proactive, and experienced in managing Medicaid applications and pending cases. The ideal candidate understands the importance of consistent follow-up, accurate documentation, and staying on top of every outstanding item until the case is resolved. If you have 5-7+ years of Medicaid or BOM experience and are ready to take ownership of a critical Medicaid operation, apply today to join a healthcare organization in partnership with HireCare Services. Apply Today Apply today to join a healthcare team committed to accountability, organization, timely follow-up, and operational excellence. #BoostRI