Medicaid Pending Representative

Job overview

The Medicaid Pending Representative role is in person in Valley Stream, NY. Compensation is described as dependent on experience, with no numeric amount specified. The role supports payer-source coordination for long-term care patients, particularly Medicaid-pending and private-pay patients. The representative helps move Medicaid applications forward, coordinates required documents with residents and responsible parties, and manages patient income and payment processes. The work also includes pre-admission screening follow-up, fair-hearing requests for denied cases, and weekly utilization reviews.

What you'll do

• Verify payer sources for Medicaid-pending and private-pay patients
• facilitate Medicaid applications and follow-up
• obtain documents and signatures from residents and responsible parties
• review financial documents, including five years of bank statements
• manage patient income setup, asset spend-down, and payments
• ensure pre-admission screenings are completed
• request fair hearings for denied cases
• conduct weekly utilization reviews
• communicate about asset balances.

What we're looking for

Skills & competencies

medicaid pending representative

valley stream ny

long-term care

medicaid applications

payer-source verification

private pay

financial document review

patient income setup

asset spend-down

pre-admission screening

fair hearings

utilization reviews

high school diploma

care network

Work arrangement

• Weekend coverage required

Why this role

High school diploma required. The posting describes compensation as dependent on experience.

About the employer

Care Network is hiring for this role. Industry: Other Individual and Family Services. Sector: 62.