Medicaid Claims Specialist

Job Summary

To support homecare agencies with Medicaid compliance, the full-time Medicaid Claims Specialist will guide users through Electronic Visit Verification (EVV) processes, resolve claims-related issues, and manage support tickets while working remotely.

Key Responsibilities

• Analyze and resolve Medicaid EVV submissions and claims issues, including payer rejections and token mismatches
• Create and manage Electronic Service Documentation (ESD) forms, ensuring proficiency in configuration tools
• Act as an escalation point for complex EVV and claims issues, liaising between support teams and state aggregators

Required Qualifications

• Bachelor's degree in a relevant field or equivalent work experience preferred
• 2+ years of experience in homecare operations, Medicaid billing, or healthcare software support, specifically with EVV and claims
• Deep understanding of Medicaid billing workflows and state-specific EVV requirements
• Experience with ticketing systems and CRM platforms
• Highly organized with the ability to manage multiple priorities in a fast-paced environment