Job Description
Job Description
Part-Time Illinois Medicaid Long-Term Care Specialist (30 Hours/Week)
Verified Medicaid Case Experience Required – Illinois Experience Strongly Preferred
We are seeking a highly experienced Medicaid professional with direct, verifiable, hands-on experience managing Long-Term Care Medicaid cases from application through approval, appeals, and reopening denied cases.
This is NOT an entry-level position.
General Medicaid knowledge alone is NOT sufficient.
Out-of-state Medicaid experience will be reviewed; however, Illinois Medicaid experience is strongly preferred, as each state operates independently with different systems, policies, and procedural requirements.
MANDATORY QUALIFICATIONS – DO NOT APPLY UNLESS YOU MEET THESE REQUIREMENTS
The candidate must have verifiable, direct experience with:
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Filing Long-Term Care Medicaid applications
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Managing cases from initial filing through approval
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Working directly with Medicaid caseworkers to resolve pending issues
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Handling OIG-related matters
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Preparing and managing appeals, including participation in administrative hearings
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Reopening denied cases and understanding procedural requirements
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Managing strict filing deadlines and timely submission requirements
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Tracking deadlines related to:
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Backdating coverage
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Appeals filings
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Reconsiderations and reopening denied cases
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Strong Preference Given To Candidates With Illinois Experience Including:
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Filing applications through the ABE (Application for Benefits Eligibility) system
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Using the MEDI system to verify eligibility and monitor case status
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Working knowledge of the Illinois Medicaid Policy Manual
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Experience with Illinois Long-Term Care billing practices and reimbursement timelines
Illinois experience must be clearly reflected on your resume and will be verified.
Preferred Additional Experience
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Experience using PointClickCare (PCC) software
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Experience working within a long-term care facility environment
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Understanding how Medicaid eligibility impacts facility billing cycles
Key Responsibilities
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File and manage LTC Medicaid applications
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Monitor eligibility and case progress
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Track and comply with all deadlines for appeals, backdating, and reopened cases
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Communicate directly with Medicaid caseworkers to secure timely approvals
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Communicate directly with Business Office Managers and Regional Business Office Managers to ensure smooth processing and follow-through of all pending cases
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Prepare documentation for OIG cases and appeals
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Ensure approvals are obtained timely to protect reimbursement
Excellent written and verbal communication skills are required.
Work Environment & Candidate Profile
This role offers excellent guidance and strong team support from management and coworkers. Collaboration is valued, and you will be part of a supportive team environment.
However, the ideal candidate must:
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Be self-motivated and able to work independently
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Be highly detail-oriented and deadline-driven
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Think critically and act quickly
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Work well with others
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Be adaptable and able to accept and tolerate procedural or policy changes
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Maintain professionalism in a fast-paced, evolving regulatory environment
Position Details
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Part-Time: 24-28 hours per week
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Compensation based on verified experience
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Independent role within a collaborative team
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Salary $40,000-$50,000 a year pending experience