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Role Description

This role involves managing the full Medicaid recertification process for residents within supported healthcare facilities.

• 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 timeously
• 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

Qualifications

• Minimum 2+ years’ experience working with medical aid processes within a healthcare, hospital, or long-term care environment
• Familiarity with U.S. Medicaid and Medicare processes, eligibility requirements, and compliance documentation is highly beneficial
• 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
• Experience working with nursing homes, skilled nursing facilities, or long-term care facilities (advantageous)
• Comfortable working within digital systems and maintaining accurate electronic records
• Proficient in MS Office and Outlook
• Excellent written and verbal English communication skills

Requirements

• Working Hours: Monday – Friday | 8:00 AM – 5:00 PM EST (2:00 PM – 11:00 PM South African time – subject to daylight savings)
• Public Holidays: This role requires working on both South African and U.S. public holidays (compensation for SA public holidays in accordance with the BCEA)
• Internet Requirements: A fixed fibre line with a minimum speed of 25 Mbps (upload & download) and wired Ethernet capability is mandatory. Applicants without a fixed fibre line cannot be considered
• Power Backup: Reliable backup required to manage load shedding or outages. Applicants without a power backup cannot be considered
• Work Environment: Fully remote

Company Description