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Remote Medicaid Jobs in Rochester, MI (NOW HIRING)

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How much do remote medicaid jobs pay per hour?

As of Sep 10, 2026, the average hourly pay for remote medicaid in Rochester, MI is $25.63, according to ZipRecruiter salary data. Most workers in this role earn between $15.91 and $30.10 per hour, depending on experience, location, and employer.

What is a remote Medicaid?

A Remote Medicaid job involves working from home to assist with Medicaid-related tasks such as processing applications, verifying eligibility, providing customer support, or managing claims. These roles can be in healthcare organizations, government agencies, or insurance companies. Responsibilities may include data entry, policy compliance, and assisting beneficiaries with their Medicaid coverage.

What are the typical daily responsibilities of a remote Medicaid?

In a Remote Medicaid position, you can expect to review and process Medicaid applications, verify eligibility, and communicate with clients or healthcare providers to gather necessary documentation. The role often involves handling sensitive client information, conducting case management tasks, and ensuring compliance with federal and state Medicaid guidelines. You may also coordinate with other team members, such as social workers, nurses, or billing specialists, using virtual collaboration tools. This remote setup allows you to manage caseloads efficiently while maintaining ongoing communication with both clients and your support team.

What are the key skills and qualifications needed to thrive in remote Medicaid, and why are they important?

To thrive in a Remote Medicaid role, you typically need knowledge of Medicaid eligibility and policy, strong organizational skills, and relevant experience in healthcare administration or case management. Familiarity with Medicaid Management Information Systems (MMIS), electronic health records (EHR), and secure telehealth platforms is highly valuable, and some positions may require certification in medical billing or coding. Outstanding attention to detail, excellent verbal and written communication, and the ability to work independently in a remote environment are crucial soft skills. These abilities ensure accurate case handling, regulatory compliance, and efficient service delivery to vulnerable populations from a distance.

What are popular job titles related to Remote Medicaid jobs in Rochester, MI?

For Remote Medicaid jobs in Rochester, MI, the most frequently searched job titles are:

What job categories do people searching Remote Medicaid jobs in Rochester, MI look for?

The top searched job categories for Remote Medicaid jobs in Rochester, MI are:

What cities near Rochester, MI are hiring for Remote Medicaid jobs?

Cities near Rochester, MI with the most Remote Medicaid job openings:

Remote Medicaid jobs near you
Infographic showing various Remote Medicaid job openings in Rochester, MI as of August 2026, with employment types broken down into 2% As Needed, 80% Full Time, 14% Part Time, 3% Contract, and 1% Nights. Highlights an 85% Physical, 2% Hybrid, and 13% Remote job distribution, with an average salary of $53,314 per year, or $25.6 per hour.

Prov Net Ops Analyst Sr

Southfield, MI • Remote

Amerihealth Caritas
Health Care and Social Assistance • 5 - 10K employees
Learn more about Amerihealth Caritasexternal

Full-time

Posted 7 days ago

AmeriHealth Caritas rating

8.3

Company rating: 8.3 out of 10

Based on 73 frontline employees who took The Breakroom Quiz

133rd of 315 rated insurance

Job description

Role Overview: The Senior Provider Network Operations Analyst serves as a subject matter expert within Provider Network Operations and is responsible for operational accuracy, regulatory compliance, claims configuration, provider data, and related network operations.

Work Arrangement:

  • Remote - This position is fully remote; the associate must be located in Michigan (MI and attend monthly meetings as needed in Southfield, MI.
  • Requires reliable high-speed internet (minimum 50 Mbps download / 5 Mbps upload)
  • Internet reimbursement may be available where required by law or contract

Responsibilities:

  • Review/approve and audit Payment Integrity (PI) vendor and internal prospective and retrospective edits/projects/recoveries.
  • User Acceptance Testing (UAT)/Client Review & audit (provider data, Appian Advanced Group ID (AGID) configuration, and set-up concentration) reviews requests prior to initial submission to Enterprise Operations (EO) and claims post-production.
  • Facets claims edit configuration concentration (Appian) - intake, review, impact assessment, and initial submission; UAT reviews requests prior to initial submission to EO and claims post-production.
  • Encounter error reconciliation representation, oversight, and management - including identification and initiation of claim or provider changes necessary to mitigate/prevent future errors.
  • Management and resolution of state complaints.
  • State policy and contract amendment changes analysis and management.
  • Internal or vendor medical policy or Health Value Optimization (HVO) edit changes and initiatives.
  • Monitor and review state communications and changes, lead initial analysis/determination of action, provide direction on work request submissions to level I analysts, and test/audit subsequent changes.
  • Business Process Outsourcing (BPO) and/or other intake/workflow tool management.
  • Single-case agreement management/ownership, including letter development and coordination with Provider Network Management (PNM).
  • Serves as the subject matter expert in state-specific health reimbursement rules and provider billing requirements and as liaison to the Enterprise Operations Configuration Department.
  • Maintain a current working knowledge of processing rules, contractual guidelines, state/Plan policy, and operational procedures to effectively provide technical expertise and business rules.
  • Acts as the resource to other departments by developing and managing work plans which document the status of key relationship issues and action items for high-profile providers.
  • Performs other related duties and projects as assigned

Education & Experience:

  • American Academy of Professional Coders (AAPC) certification (CPC, COC, CIC, CRC) or NHA (CBCS) certification required.
  • Associate's degree preferred, or equivalent combination of education and experience in a healthcare field.
  • 3 to 5 years of claims analysis experience in healthcare, managed care, or Medicaid environment preferred.
  • Claims processing and Provider data maintenance knowledge required
  • Understanding of and experience related to healthcare claims payment configuration process/systems and its relevance/impact on network operations required
  • Strong working knowledge of Microsoft Excel, Access, Word, and other MS Office tools; ability to work with pivot charts, Access databases, and data analytics.

Skills & Abilities:

  • Ability to focus on technology and business issues, as well as communicate appropriately with both technology and business experts
  • Strong analytic problem-solving skills
  • Superior organizational skills required
  • Critical thinking skills
  • Strong customer service skills
  • Data and reporting analysis
Employment Type: FULL_TIME

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