Government Programs & Reimbursement Coordinator
CommonSail Investment Group
Position Summary:
The Government Programs & Reimbursement Coordinator is responsible for the coordination, research, application processing, compliance tracking, and billing oversight for Medicaid waiver participation across StoryPoint Group assisted living and memory care communities and CorsoCare Personal Care in multiple states.
This role serves as the internal subject matter resource for Home and Community-Based Services (HCBS) waivers, state-specific Medicaid programs, VA, GUIDE program and other government payor type programs. The Coordinator ensures timely enrollment, accurate documentation, regulatory compliance, and proper billing processes to support operational success and revenue integrity.
This position works cross-functionally with Compliance, Operations, Clinical, Finance, and Revenue teams to support sustainable waiver participation aligned with our Safety First commitment and regulatory excellence standards.
Required Experience for Government Programs & Reimbursement Coordinator:
1. Education: Bachelor’s degree preferred (Healthcare Administration, Business, Public Health, or related field).
2. Experience: 2–5 years experience in healthcare administration, Medicaid programs, senior living, or long-term care.
3. Program Knowledge: Familiarity with Medicaid waiver or managed care programs preferred.
4. Regulatory Knowledge: Multi-state regulatory exposure preferred.
5. Billing Knowledge: Experience with healthcare billing processes strongly preferred.
Primary Responsibilities for Government Programs & Reimbursement Coordinator:
6. Research & Program Tracking
7. Research state-specific Medicaid waiver requirements and program updates.
8. Monitor changes to HCBS regulations and state waiver amendments.
9. Maintain a multi-state waiver tracking matrix including: Enrollment status Renewal deadlines Required documentation Managed care participation
10. Prepare summaries of regulatory updates for leadership review.
2. Application & Enrollment Coordination
11. Coordinate and prepare Medicaid waiver provider enrollment applications.
12. Collect required documentation from communities and corporate departments.
13. Track submission timelines and follow up with state agencies and MCOs as applicable.
14. Maintain organized records of: Provider enrollments Credentialing approvals Attestations Site readiness inspections
15. Serve as point of contact for state Medicaid agencies during application processes.
3.Compliance Monitoring
16. Maintain waiver compliance checklists for participating communities.
17. Track required documentation such as: Service plans Eligibility verification Staffing requirements HCBS setting compliance attestations
18. Support internal audits and assist with corrective action tracking.
19. Coordinate documentation for state audits or desk reviews.
20. Maintain waiver policies and procedures library.
4. Billing & Revenue Coordination
21. Collaborate with Revenue Cycle and Finance teams to: Ensure waiver billing processes are properly implemented. Confirm documentation supports billed services. Track denials or payment discrepancies.
22. Maintain waiver billing logs and reconciliation reports.
23. Assist with investigation of billing issues or recoupment concerns.
24. Develop tracking tools to monitor billing accuracy and timeliness.
5. Operational Support & Training
25. Support communities in onboarding waiver residents by: Providing documentation guidance. Reviewing required forms. Clarifying service requirements.
26. Assist in development of waiver training materials for: Executive Directors Wellness Directors Property Administrators
27. Provide ongoing support for waiver-related questions from field teams.
6. Reporting & Communication
28. Maintain centralized dashboards.
29. Prepare monthly status reports on: Enrollment activity Compliance metrics Billing trends
30. Escalate risks or compliance concerns to leadership.
31. Participate in cross-functional meetings related to Medicaid and reimbursement.
Accountability Metrics:
32. Timely and accurate submission of waiver applications.
33. Zero missed enrollment or renewal deadlines.
34. Billing accuracy rate in collaboration with Revenue Cycle.
35. Audit documentation readiness.
36. Reduction in waiver-related denials or recoupments.
37. Accurate tracking of waiver participation across all states.
Skills for Success:
38. Building solid cross-functional relationships aligned with the organization's 1440 Care Standards.
39. Strong organizational skills
40. Regulatory research capability
41. Attention to detail
42. Project coordination
43. Financial and billing awareness
44. Cross-functional communication
45. Deadline management
Travel: Minimal to moderate travel as needed for state inspections or operational support.
General Working Conditions: This position involves frequent standing, sitting, and walking. The employee will regularly communicate effectively, handle keyboards, telephones, and documentation. Occasional lifting of up to 25 pounds may be required. Occasional travel to community locations is expected. The work environment involves moderate noise levels and requires positive interaction with colleagues and residents.
Equal Opportunity Employer
StoryPoint Group is committed to fostering a culture of excellence, safety, and continuous improvement in all areas of resident care.
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