Nursing Home Medicaid Specialist - Moskowitz Legal Group - Hewlett

Job Overview
We are seeking a dedicated and detail-oriented Nursing Home Medicaid Specialist to join our team. In this vital role, you will serve as a key resource in navigating the complex Medicaid reimbursement process for nursing home residents. Your expertise will ensure compliance with state and federal regulations, facilitate accurate documentation, and support residents' access to necessary benefits. This position offers an exciting opportunity to make a meaningful impact on patient care and facility operations through proactive case management and thorough knowledge of healthcare policies.
Duties

• Review and interpret medical records, discharge summaries, and clinical documentation to determine Medicaid eligibility for nursing home residents
• Collaborate with social workers, healthcare providers, and discharge planners to gather necessary documentation and ensure timely processing of Medicaid applications
• Conduct intake assessments, verify patient information, and facilitate the submission of Medicaid claims in accordance with state guidelines
• Utilize CPT (Current Procedural Terminology) coding, ICD-9, and ICD-10 coding systems to accurately classify diagnoses and procedures for billing purposes
• Maintain comprehensive medical records, ensuring HIPAA compliance and confidentiality at all times
• Assist with case management by coordinating services, supporting discharge planning, and addressing behavioral health or pediatric needs when applicable
• Stay current on Medicaid policies, hospital experience requirements, and medical coding updates to ensure ongoing compliance and optimal reimbursement
  Requirements
• Proven experience in hospital or healthcare settings, particularly with acute care environments or discharge planning processes
• Strong knowledge of medical terminology, CPT coding, ICD-9/ICD-10 coding systems, and medical records management
• Familiarity with social work practices, behavioral health considerations, pediatrics (if applicable), and patient service protocols
• Understanding of HIPAA regulations to safeguard patient information during all stages of case management
• Excellent organizational skills with the ability to manage multiple cases efficiently under tight deadlines
• Effective communication skills to collaborate across multidisciplinary teams and explain complex processes clearly
• Prior experience with intake procedures, case management strategies, and familiarity with hospital-based billing practices is highly desirable
  Join us in this rewarding role where your expertise will directly contribute to improving resident outcomes while supporting our facility’s operational excellence. We are committed to fostering a dynamic environment that values your skills and dedication as we work together to provide exceptional care.