About the Role
We're looking for an experienced Medicaid Liaison to manage the Medicaid eligibility for Tennessee/Kentucky facilities and application process for our residents. In this role, you'll serve as the critical link between our residents and families, our business office and social services teams, and county/state Medicaid caseworkers — making sure every Medicaid-pending application moves forward accurately and on schedule. This is a hands-on, detail-driven role for someone who knows long-term care Medicaid inside and out and takes pride in getting residents approved without unnecessary delay.
Key Responsibilities
- Serve as the facility's primary point of contact with county Departments of Social Services (DSS) and state Medicaid agencies for resident eligibility matters in the states of Tennessee and Kentucky.
- Manage the full Medicaid application lifecycle for residents: initial screening, application preparation and submission, follow-up, and resolution through approval.
- Guide residents and family members through required documentation — income verification, asset statements, spend-down calculations, and transfer/look-back disclosures — and help them gather and complete paperwork accurately.
- Track all Medicaid-pending accounts and proactively follow up with caseworkers to prevent stalled or lapsed applications.
- Partner closely with the business office/billing team to monitor Medicaid-pending A/R aging and convert accounts to active Medicaid billing status promptly upon approval.
- Identify and resolve issues that could delay eligibility, including missing documentation, excess resources, transfer penalties, and redetermination requirements.
- Respond to denials and assist with appeals, including preparing supporting documentation and representing the facility in fair hearings when needed.
- Maintain accurate, up-to-date resident financial and eligibility records within the facility's EHR/billing system (e.g., PointClickCare).
- Educate admissions, social services, and clinical staff on Medicaid eligibility criteria, timelines, and documentation requirements.
- Stay current on state and federal Medicaid regulations, including changes to eligibility rules, spend-down thresholds, and long-term care policy.
- Attend care conferences, utilization review, and interdisciplinary team meetings as needed to represent the resident's financial/eligibility status.
Qualifications
- 2+ years of experience with Medicaid eligibility casework, long-term care/SNF business office operations, or a comparable Medicaid liaison role.
- Working knowledge of Medicaid long-term care eligibility rules, including spend-down, resource limits, and asset transfer/look-back provisions in the states of Tennessee and Kentucky.
- Strong organizational skills with the ability to manage a high volume of pending applications and deadlines simultaneously.
- Excellent written and verbal communication skills for working with residents, families, facility staff, and county/state case workers.
- High attention to detail and strong follow-up habits — nothing falls through the cracks on your watch.
- Comfortable navigating sensitive financial and family conversations with empathy and professionalism.
- Proficiency with Microsoft Office/Google Workspace; experience with PointClickCare (PCC) or a similar SNF EHR/billing platform is a plus.
- Experience as a Business Office Manager in a skilled nursing facility is a plus.
Benefits:
- 401(k)
- Dental insurance
- Disability insurance
- Health insurance
- Paid time off
- Vision insurance
Work Location: In person
