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How much do medicaid software jobs pay per hour?

As of Aug 15, 2026, the average hourly pay for medicaid software in the United States is $61.71, according to ZipRecruiter salary data. Most workers in this role earn between $49.76 and $69.71 per hour, depending on experience, location, and employer.

What is the difference between Medicaid Software vs Medicaid Claims Specialist?

AspectMedicaid SoftwareMedicaid Claims Specialist
Primary RoleSoftware tools used to manage Medicaid data, billing, and complianceProcessing and reviewing Medicaid claims for accuracy and reimbursement
Required SkillsTechnical skills, software proficiency, data managementKnowledge of Medicaid policies, claims processing, attention to detail
Work EnvironmentHealthcare IT companies, software vendors, healthcare providersHealthcare facilities, insurance companies, Medicaid agencies
CertificationsNone typically required, but IT certifications helpfulMedical billing certifications, Medicaid-specific training

Medicaid Software refers to the tools and systems used to manage Medicaid data and billing processes, while Medicaid Claims Specialists focus on processing and verifying Medicaid claims. Both roles are essential in the Medicaid industry but serve different functions—one in software management and the other in claims processing.

What are some common challenges faced by professionals working with Medicaid software systems?

Professionals working with Medicaid software often encounter challenges such as navigating frequently changing federal and state regulations, integrating new modules with legacy systems, and ensuring data security and privacy in compliance with HIPAA. Additionally, collaborating with diverse stakeholders—including healthcare providers, government agencies, and IT teams—requires strong communication and project management skills. Staying updated with evolving technology standards and maintaining system interoperability are also key aspects of the role.

What are the key skills and qualifications needed to thrive as a Medicaid software specialist, and why are they important?

To thrive as a Medicaid Software Specialist, you need a solid background in healthcare IT, knowledge of Medicaid regulations, and experience with software development or implementation, typically supported by a degree in computer science or health informatics. Familiarity with Medicaid Management Information Systems (MMIS), claims processing tools, and compliance software is essential. Strong analytical skills, attention to detail, and effective communication help bridge the gap between technical teams and healthcare administrators. These skills ensure efficient, compliant, and user-friendly Medicaid systems that support both organizational goals and regulatory requirements.

What is Medicaid software?

Medicaid software refers to specialized technology platforms and applications designed to support the administration, management, and delivery of Medicaid health programs. These software systems help state agencies, healthcare providers, and payers manage eligibility, claims processing, member enrollment, reporting, and compliance with federal and state regulations. Medicaid software plays a crucial role in improving efficiency, reducing errors, and ensuring that Medicaid beneficiaries receive appropriate coverage and services. It can include modules for case management, billing, analytics, and provider management. Modern Medicaid software often integrates with other health information systems to facilitate seamless data exchange.
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What cities are hiring for Medicaid Software jobs?

Cities with the most Medicaid Software job openings:

What states have the most Medicaid Software jobs?

States with the most job openings for Medicaid Software jobs include:

What job categories do people searching Medicaid Software jobs look for?

The top searched job categories for Medicaid Software jobs are:

Medicaid Software jobs near you
Infographic showing various Medicaid Software job openings in the United States as of August 2026, with employment types broken down into 1% Internship, 87% Full Time, 8% Part Time, and 4% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $128,367 per year, or $61.7 per hour.

Medicaid Eligibility Specialist (PA / Hybrid)

FreedomCare

Philadelphia, PA • On-site, Remote

Full-time

Medical, Retirement

Posted 10 days ago

FreedomCare rating

6.9

Company rating: 6.9 out of 10

Based on 46 frontline employees who took The Breakroom Quiz

49th of 240 rated social care providers

Job description

FreedomCare is a healthcare company that has been dedicated to revolutionizing the home care industry since 2016. We support our patients by ensuring they have the power to choose a caregiver who will care for them in the comfort of their own homes. Our mission spans coast to coast, supporting patients across the U.S.
We pride ourselves on our values which drive the level of care that we deliver to our patients:
  • Here For You (An attitude of service, empathy, and availability)
  • Own It (Drive and ownership)
  • Do the Right Thing (High integrity)
  • Be Positive (Great attitude and a can-do positive approach to challenges)

Join our team and make a positive impact on the lives of others! We are looking for a Medicaid Eligibility Specialist for our Pennsylvania Operations Team.
This is a hybrid role that requires a regularly scheduled commute/travel to our main office in Pittsburgh, Philadelphia, and/or the FreedomCare hub closest to you.
Department & Position Overview:
The Medicaid Eligibility Specialist focuses on enhancing the patient's experience by facilitating the approval process, to allow them to receive our service. The Medicaid Specialist responsible for expediting the time it takes for them to enroll into our programs.
The Specialist focuses on maintaining eligibility with current consumers' service by maintaining active Medicaid status through Medicaid recertification and monthly spend down obligations.
The Specialist will be responsible for ensuring compliance with all relevant regulations. The Specialist requires a high level of attention to detail, excellent communication skills, and requires in-depth knowledge and understanding of Medicaid policies, regulations, and procedures.
Every Day You Will:
Medicaid Eligibility
  • Provide clients with information and guidance on Medicaid eligibility requirements and benefits
  • Address client inquiries and concerns related to Medicaid applications, renewals, and coverage
  • Manage alternative resources for clients to meet Medicaid eligibility requirements
  • Conduct client education sessions on Medicaid programs and benefits
  • Subject matter expert relative to Pennsylvania Medicaid spenddown requirements through the clients' pre-care & on care status

Medicaid Renewal Processing:
  • Monitor and manage the Medicaid renewal process for existing clients
  • Notify clients of upcoming renewal deadlines and assist with the submission of required documentation
  • Ensure that renewals are processed in a timely manner to avoid lapses in coverage

Documentation and Record Keeping:
  • Maintain accurate and detailed records of verification processes and outcomes
  • Update patient records in salesforce to reflect current Medicaid status
  • Design Medicaid eligibility and spenddown process along with trackability reports in Salesforce

Communication:
  • Serve as a point of contact for Medicaid inquiries from clients, caregivers, and Health plan partners
  • Assist clients in understanding Medicaid eligibility, benefits, and application processes
  • Advocate for clients to ensure they receive appropriate Medicaid services
  • Respond to inquiries from patients and healthcare providers regarding Medicaid coverage and eligibility

Collaboration and Support:
  • Work closely with partnering departments to resolve any issues related to Medicaid coverage and recertification
  • Assist with training staff members on Medicaid verification procedures and policies
  • Collaborate with partnering departments, case managers, and other healthcare professionals to support patients' access to Medicaid benefits
  • Identify and resolve issues that may affect clients' Medicaid eligibility or coverage
  • Work with government agencies and other stakeholders to address and resolve complex Medicaid-related cases

Ideal Candidate Will Possess:
  • Associate's or Bachelor's degree in Social Work, Healthcare Administration, Public Health, or a related field preferred
  • Minimum of 2 years of experience in Medicaid, healthcare, or social services
  • Experience in client support, case management, or benefits coordination
  • Minimum of 2 years of understanding of the Medicaid eligibility and application process for the state of Pennsylvania
  • Excellent organizational and time management skills
  • Proficient in using case management software and other relevant technology
  • Strong communication and interpersonal skills, with the ability to work effectively with diverse populations
  • Ability to analyze complex information and make informed decisions

Why work at FreedomCare?
We are here for you and committed to providing a best-in-class employee experience. We offer competitive compensation, medical benefits, retirement plans, wellness programs, fun company events and ongoing learning opportunities to grow your career.
This is a place where your voice matters, where we build great relationships, and your work has meaning and a tangible positive impact on others!
At FreedomCare, we celebrate diversity and are committed to creating an inclusive environment for all employees. We are an Equal Opportunity Employer and do not discriminate based upon race, religion, color, national origin, ancestry, age, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, status as a protected veteran, status as an individual with a disability, citizenship or immigration status, or other applicable legally protected characteristics.
At FreedomCare, base pay is one part of our total compensation package and is determined within a range. This provides our employees with the opportunity to professionally grow and develop within a role. The base pay range for this role is between $23.00 and $25.00 an hour at the commencement of your first year of employment. Compensation decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.
Compensation Range
$23-$25 USD

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