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Medicaid Program Integrity Jobs in Kentucky (NOW HIRING)

Onco360

Pharmacy Prior Authorization Specialist

Louisville, KY · On-site +1

$18.75 - $24.25/hr

We value teamwork, respect, integrity, and passion . * Growth opportunities: We invest in your ... Referral Incentive Program * Company Paid Life Insurance; and Short/Long-Term Disability What You ...

Onco360

Pharmacy Prior Authorization Specialist

Louisville, KY · On-site

$19.75 - $25.50/hr

We value teamwork, respect, integrity, and passion . * Growth opportunities: We invest in your ... Referral Incentive Program * Company Paid Life Insurance; and Short/Long-Term Disability What You ...

Integritymarketing

Agent Sales-1

Manchester, KY

... Savings Program and prescription drug coverage programs. For more information, visit ... About Integrity Integrity is one of the nation's leading independent distributors of life, health ...

Integritymarketing

Agent Sales-2

Manchester, KY

... Savings Program and prescription drug coverage programs. For more information, visit ... About Integrity Integrity is one of the nation's leading independent distributors of life, health ...

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All JobsMedicaid Program Integrity JobsMedicaid Program Integrity Jobs in Kentucky

Medicaid Program Integrity information

What is the difference between Medicaid Program Integrity vs Medicaid Claims Examiner?

AspectMedicaid Program IntegrityMedicaid Claims Examiner
Primary FocusDetecting and preventing fraud, waste, and abuse in Medicaid programsReviewing and processing Medicaid claims for accuracy and compliance
Required CredentialsTypically healthcare or compliance certifications, knowledge of Medicaid policiesHealthcare or claims processing certifications, attention to detail
Work EnvironmentRegulatory agencies, government offices, compliance departmentsInsurance companies, healthcare providers, government Medicaid offices

Medicaid Program Integrity professionals focus on safeguarding Medicaid funds by identifying fraudulent activities, while Medicaid Claims Examiners primarily verify claims for accuracy and proper coding. Both roles require healthcare knowledge and certifications but differ in their core responsibilities and work settings.

What are popular job titles related to Medicaid Program Integrity jobs in Kentucky? For Medicaid Program Integrity jobs in Kentucky, the most frequently searched job titles are:
What job categories do people searching Medicaid Program Integrity jobs in Kentucky look for? The top searched job categories for Medicaid Program Integrity jobs in Kentucky are:
What cities in Kentucky are hiring for Medicaid Program Integrity jobs? Cities in Kentucky with the most Medicaid Program Integrity job openings:
Medicaid Program Integrity jobs near you
Infographic showing various Medicaid Program Integrity job openings in Kentucky as of July 2026, with employment types broken down into 80% Full Time, 9% Part Time, and 11% Contract. Highlights an 87% In-person, and 13% Remote job distribution.
Medicaid/Medicare Services Specialist I

Medicaid/Medicare Services Specialist I

Commonwealth of Kentucky

Frankfort, KY • On-site

$39K - $58K/yr

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

Advertisement Closes
7/25/2026 (11:59 PM ET)
2603577
Medicaid/Medicare Services Specialist I
Pay Grade13
Salary
$39,284.88 - $58,927.20 Annually
Employment Type
EXECUTIVE BRANCH FULL TIME ELIGIBLE FOR OVERTIME PAY 18A 37.5 HR/WK
Click here for more details on state employment.
Hiring Agency
Cabinet for Health & Family Services Department for Medicaid Services
Location
275 E Main St
Frankfort, KY 40621 USA
The agency may authorize the selected candidate to telecommute. The agency may terminate or modify thetelecommuting arrangement at any time.
Description
This position is located in Frankfort, KY and must come to theoffice three days per week.
The Department for Medicaid Services (DMS) provides health care access for eligible low-income residents ofKentucky including children, families, pregnant women, the aged and the disabled as well as a number ofprograms and services directed at specific eligibility and medical needs. DMS strives each day to meet themission of the Cabinet for Health and Family Services to be a diverse and inclusive organization providingprograms, services and supports that protect and promote the health and well-being of all Kentuckians andtheir communities.
The Department for Medicaid Services, Division of Program Integrity is responsible for guarding Medicaidagainst fraud, waste and abuse of program benefits by providers and members, and compliance with federal andstate rules and regulations. The Medicaid / Medicare Services Specialist I offers a wide-range of learningopportunities, including networking as this position will work closely with Providers, Managed CareOrganizations, Management, and sister-agencies. Seeking a motivated person that will work in a high-volumecontact center for the Department for Medicaid Services, Provider Enrollment where identifying customers'needs quickly, clarifying information, and researching every issue is required in order to provide resolutionsto issues. To be successful, candidates should be professional, polite, and able to deal with difficult andstressful situations, and able to apply state and federal regulations in decision making.
Learn more about us at: https://chfs.ky.gov/agencies/dms/Pages/default.aspx
Responsibilities and Duties:
  • Provide specialized assistance to Medicaid providers, staff within the Department for MedicaidServices, and Medicaid Contractors.
  • Respond to providers and Credentialing Agents inquiries on Kentucky Department for Medicaid ServicesProvider Enrollment eligibility, submission documents, and application status, as well as maintenance requiredon provider file.
  • Collecting information about caller and provider, verifies in different information systems, andenters information into database.
  • Entering information into the Customer Relationship Management (CRM) systemto assist with call-tracking and quality assurance.
  • Provides assistance to providers and government agencies through oral and written response to inquiries.
  • Requires the ability to work independently and manage time effectively, as well as to work with difficultissues.
  • Implements policy changes as appropriate.
  • Performs research of state and federal statutes and regulations relative to provider enrollment
  • Remains abreast of all changes to state and federal laws.
Preferred Knowledge, Skills and Abilities:
  • Strong ability in working with Medicaid Partner Portal Application, Medicaid Management InformationSystem, and other provider enrollment research tools.
  • Excellent verbal and written communication skills.
  • Excellent computer skills, especially in Microsoft Office, with experience using Excel.
  • Ability to work independently, with attention to detail; thoroughness and accuracy in completing tasks.
  • Ability to apply state and federal regulations to work outcomes.
The Cabinet for Health and Family Services (CHFS) participates in E-Verify and will provide the federalgovernment with your Form I-9 information to confirm that you are authorized to work in U.S. CHFS will onlyuse E-Verify once you have accepted a job offer and completed the Form I-9. For more information on E-Verify,or if you believe that CHFS has violated its E-Verify responsibilities, please contact Department of HomelandSecurity (DHS) at 888-897-7781 or https://dhs.gov/e-verify
Minimum Requirements
EDUCATION:Graduate of a college or university with a bachelor's degree.
EXPERIENCE, TRAINING, OR SKILLS:NONE
Substitute EDUCATION for EXPERIENCE:NONE
Substitute EXPERIENCE for EDUCATION:Experience in Medicaid and/or Medicare program administration, health insurance administration/systems, eligibility systems, health care research, health care planning, health care financial management, health care policy development or human service or health care administration, insurance billing and/or claims will substitute for the required college on a year-for-year basis. Current or prior military experience will substitute for the required college on a year-for-year basis.
SPECIAL REQUIREMENTS (AGE, LICENSURE, REGULATION, ETC.):NONE
Working Conditions
Incumbents working in this job title primarily perform duties in an office setting.
Probationary Period
This job has an initial and promotional probationary period of 6 months, except as provided in KRS 18A.111.
If you have questions about this advertisement, please contact Melissa Cox at Melissa.Cox@ky.gov or 502-564-6303.
An Equal Opportunity Employer M/F/D

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