LIFE Pittsburgh · 2 months ago
Financial Eligibility Specialist
Pittsburgh,PA,US
Full-time
Hybrid
Mid Level
$50K/yr - $62K/yr
3+ years expLIFE Pittsburgh is a growing nonprofit organization that provides community-based alternatives to nursing home care. The Financial Eligibility Specialist plays a critical role in securing and maintaining Medicaid financial eligibility for Participants, ensuring accurate documentation and proactive communication throughout the eligibility process.
Health CareNon ProfitNursing and Residential Care
Responsibilities
Lead the timely completion and submission of Medicaid applications or renewals, ensuring documentation is accurate, comprehensive, and aligned with current eligibility criteria
Evaluate each case for specific financial conditions or red flags that may impact eligibility
Assist Participants and/or their caregivers in gathering financial documents through phone, email, or in-home visits as needed
Manage ongoing renewals and recertifications for enrolled Participants, ensuring timely submission prior to expiration
Monitor all presumptive enrollment cases for timely resolution and accurate documentation
Identify potential eligibility risks prior to formal enrollment, escalating concerns to leadership as appropriate
Ensure Medicaid applications are submitted swiftly and accurately to minimize financial risk to the organization
Serve as the liaison between LIFE Pittsburgh and the CAO
Conduct regular case status calls with CAO representatives and maintain collaborative communication
Respond to all CAO correspondence including pending letters, additional information requests, denials, approvals, and appeals
Prepare and submit appeals as needed, collaborating with the Enrollment and Compliance teams
Maintain daily updates in the Medicaid Tracker to reflect the real-time status of each case
Document all communications, submissions, and follow-up actions to ensure transparency and accountability
Support internal reporting needs through accurate and complete case data
Provide support and training to new team members or Enrollment Specialists on financial eligibility workflows
Contribute to the development and continuous improvement of Medicaid-related procedures, job aids, and training resources
Identify trends or recurring issues and recommend solutions to streamline processes
Assist with incoming calls and general department functions
Support a team culture aligned with LIFE Pittsburgh’s mission, values, and service philosophy
Qualification
Required
Strong critical thinking and situational analysis skills
High attention to detail and organizational accuracy
Ability to manage multiple, time-sensitive cases with professionalism and urgency
Effective communication skills — both written and verbal — with Participants, families, and professionals
Working knowledge of Microsoft Office and electronic tracking systems
Valid driver's license, proof of insurance, and access to a reliable vehicle are required. Local travel is frequent
High school diploma or equivalent required; associate or bachelor's degree preferred
3–5 years' experience in Medicaid eligibility, long-term care benefits, or related financial case management strongly preferred
Demonstrated understanding of bank statements, assets, and financial documentation required
Preferred
associate or bachelor's degree preferred
3–5 years' experience in Medicaid eligibility, long-term care benefits, or related financial case management strongly preferred
Benefits
Rich Benefits Package including Medical, Dental, and Vision
401(k) with Company Match, vested immediately.
Life Insurance
Tuition Reimbursement
Paid Time Off – Grows every pay period and rolls over into new year!
Company
LIFE Pittsburgh
LIFE Pittsburgh is a nonprofit organization that provides nursing home care services.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Carrie Pappal
Chief Nursing Officer
Company data provided by crunchbase