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:

• Filing Long-Term Care Medicaid applications
• Managing cases from initial filing through approval
• Working directly with Medicaid caseworkers to resolve pending issues
• Handling OIG-related matters
• Preparing and managing appeals, including participation in administrative hearings
• Reopening denied cases and understanding procedural requirements
• Managing strict filing deadlines and timely submission requirements
• Tracking deadlines related to:
• Backdating coverage
• Appeals filings
• Reconsiderations and reopening denied cases

Strong Preference Given To Candidates With Illinois Experience Including:

• Filing applications through the ABE (Application for Benefits Eligibility) system
• Using the MEDI system to verify eligibility and monitor case status
• Working knowledge of the Illinois Medicaid Policy Manual
• 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

• Experience using PointClickCare (PCC) software
• Experience working within a long-term care facility environment
• Understanding how Medicaid eligibility impacts facility billing cycles

Key Responsibilities

• File and manage LTC Medicaid applications
• Monitor eligibility and case progress
• Track and comply with all deadlines for appeals, backdating, and reopened cases
• Communicate directly with Medicaid caseworkers to secure timely approvals
• Communicate directly with Business Office Managers and Regional Business Office Managers to ensure smooth processing and follow-through of all pending cases
• Prepare documentation for OIG cases and appeals
• 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:

• Be self-motivated and able to work independently
• Be highly detail-oriented and deadline-driven
• Think critically and act quickly
• Work well with others
• Be adaptable and able to accept and tolerate procedural or policy changes
• Maintain professionalism in a fast-paced, evolving regulatory environment

Position Details

• Part-Time: 30 hours per week
• Compensation based on verified experience
• Independent role within a collaborative team
• Salary $40,000-$50,000 a year pending experience