Center for Transitional Living are seeking an experienced Medicaid Billing & Program Specialist to support our rapidly growing Medicaid home care operations in Michigan and Connecticut.
The ideal candidate will have direct experience with Michigan Medicaid Home Help, CHAMPS, and/or Connecticut Medicaid waiver programs, including CHCPE, DDS, ABI, MFP/CSP, and other long-term services and supports (LTSS). This individual will serve as a subject matter expert for billing operations, provider enrollment, claims resolution, Medicaid compliance, and payer navigation while helping support agency growth across both states.
Responsibilities
- Manage Michigan and Connecticut Medicaid billing and claims processes.
- Submit, track, reconcile, and resolve MDHHS Home Help and Connecticut Medicaid claims.
- Work within CHAMPS to maintain provider enrollments, updates, revalidation, and compliance requirements.
- Navigate Connecticut Medicaid billing portals and payer systems.
- Identify and resolve claim denials, rejections, payment issues, and billing discrepancies.
- Coordinate with MDHHS, Connecticut DSS, CHAMPS support, Gainwell, Medicaid Managed Care Organizations (MCOs), and agency staff regarding billing concerns.
- Monitor payment activity, accounts receivable, and reimbursement trends.
- Assist with provider enrollment, credentialing, and ongoing compliance requirements.
- Support audits, compliance reviews, and documentation requests.
- Develop billing workflows, internal procedures, and process improvements to maximize collections.
- Train administrative staff on Michigan and Connecticut Medicaid billing requirements.
- Serve as an internal resource for Medicaid policy questions and operational guidance.
- Assist leadership with implementation of new Medicaid programs, payer contracts, and expansion initiatives.
Required Qualifications
- Minimum of 2 years of Medicaid billing experience.
- Strong knowledge of Michigan Medicaid and/or Connecticut Medicaid programs.
- Experience working with CHAMPS and/or Connecticut Medicaid billing systems.
- Experience resolving Medicaid claim denials, payment issues, and billing discrepancies.
- Understanding of Medicaid provider enrollment and compliance requirements.
- Strong organizational, analytical, and communication skills.
- Ability to work independently while managing multiple priorities.
Pay: $25.00 - $30.00 per hour
Benefits:
Work Location: Hybrid remote in Norwalk, CT 06858
