
Medicaid specialist assistant Cook County
Allure Healthcare Services
Cook County, IL
Manufacturing / Production, Business Management / Project / Planning
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:
Preferred Additional Experience
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:
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
- 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
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
- 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
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
- Part-Time: 30 hours per week
- Compensation based on verified experience
- Independent role within a collaborative team
- Salary $40,000-$50,000 a year pending experience
About the company
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