Job Description
Work Setup: Permanent Work-From-Home (WFH) position
Position Summary:
The Medicaid Compliance & Payer Policy Manager is a highly skilled Medicaid billing expert responsible for ensuring Client maintains accurate, compliant Medicaid billing across all states. This role serves as the organization’s Medicaid subject-matter authority—monitoring requirements, reducing denials, overseeing compliance efforts, and supporting implementation as new Medicaid contracts are added. In addition, this role manages payer policy reviews across all major payers, ensuring RCM workflows, provider guidance, and system configuration remain aligned and up-to-date. While this position may oversee one or two billing agents, it is primarily a hands‑on, expert-level role requiring independent ownership of Medicaid processes, coding requirements, and payer compliance.
Key Responsibilities
Medicaid Billing & Compliance Leadership:
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