ISTA Personnel Solutions is hiring a Medicaid Recertification Specialist to provide critical administrative support for our healthcare partners. In this remote role, you will manage the full Medicaid recertification process to ensure compliance and continuity of resident funding, working closely with facility staff and state agencies during EST hours.
What You'll Do
- Manage the full Medicaid recertification process, including tracking timelines and submission deadlines.
- Review resident files to ensure all documentation meets Medicaid compliance standards.
- Coordinate with facility staff to obtain required documentation and outstanding information.
- Prepare and submit recertification documentation accurately and on time.
- Communicate with state Medicaid agencies and facility billing departments where required.
- Maintain accurate and up-to-date records within internal systems.
- Identify documentation gaps and proactively resolve compliance issues.
- Ensure recertifications are completed before eligibility expiration to prevent funding disruptions.
- Provide additional administrative and operational support to facilities as needed.
What We're Looking For
- Minimum 2+ years’ experience working with medical aid processes within a healthcare, hospital, or long-term care environment.
- Experience handling high-volume case files or time-sensitive administrative processes.
- Strong understanding of compliance-driven environments and regulatory documentation standards.
- Highly detail-oriented with the ability to manage strict deadlines and multiple resident files simultaneously.
- Comfortable working within digital systems and maintaining accurate electronic records.
- Proficient in MS Office and Outlook.
- Excellent written and verbal English communication skills.
- Fixed fibre line with a minimum speed of 25 Mbps (upload & download) and wired Ethernet capability.
- Reliable power backup to manage load shedding or outages.
Nice to Have
- Familiarity with U.S. Medicaid and Medicare processes, eligibility requirements, and compliance documentation.
- Experience working with nursing homes, skilled nursing facilities, or long-term care facilities.
Technical Stack
- MS Office
- Outlook
Team & Environment
You will be working alongside a team that delivers administrative, financial, and operational support to nursing homes and long-term care facilities.
Benefits & Compensation
- Compensation for South African public holidays in accordance with the BCEA.
Work Mode
This is a remote position requiring you to work Eastern Standard Time (EST) hours.
ISTA Personnel Solutions is an equal opportunity employer.
