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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: 24-28 hours per week

• Compensation based on verified experience

• Independent role within a collaborative team

• Salary $40,000-$50,000 a year pending experience