Medicaid Coordinator

Job Summary

The Medicaid Coordinator is responsible for assisting clients with Medicaid eligibility enrollment, recertification, and on-going case management in compliance with New York State and New York City Human Resources Administration (HRA) regulations. This roll serves as a liaison between clients, healthcare providers, managed care organizations, and government agencies to ensure uninterrupted Medicaid coverage and access to services.

 Key Responsibilities:

• Assist clients with Medicaid applications, renewals, recertifications, and changes in coverage.
• Determine eligibility based on New York State and City guidelines, income, and residency requirements.
• Collect, review, and submit required documentation to NYC HRA and NY State of Health
• Monitor case statuses and follow up on pending applications or required documentation.
• Coordinate with healthcare providers, managed care plans, and social services agencies.
• Educate clients and families on Medicaid benefits, managed care options, and available services.
• Maintain accurate and timely documentation in electronic and paper case management systems.
• Resolve coverage issues, denials, or terminations through appeals or corrective action.
• Ensure compliance with HIPPA and confidentiality regulations.
• Stay current on changes to NYS Medicaid policies, HRA procedures, and managed care plans.

 Qualifications

• High School diploma or equivalent required; associate or bachelor’s degree in social work, healthcare administration, or related field preferred
• 1-3 years of experience working with Medicaid, public benefits, or healthcare eligibility programs (NYC experience strongly preferred)
• Knowledge of NYS Medicaid, NYC HRA processes, and managed care plans
• Strong organizational and documentation skills
• Excellent verbal and written communication skills
• Ability to work with diverse populations in a challenging environment.
• Proficiency in Microsoft Office and electronic case management systems
• Bilingual (Spanish, Mandarin, Cantonese, Russian, or other NYC-relevant languages) a plus

Preferred Skills

• Experience with vulnerable populations (seniors, individuals with disabilities)
• Familiarity with long-term Medicaid, Medicaid Managed Long-Term Care (MLTC), or home care services.
• Strong problem-solving and advocacy skills

Work Environment

• Office, healthcare facility, or community- based setting
• May require interaction with government agencies and external partners.

Job Type: FULL-TIME

Benefits: 

Medical Insurance

Dental & Vision

401K

PTO