Discover a Career with Circle of Care St Louis

Position Summary

The Medicaid Billing & HCBS Scheduling Specialist is a client-facing, high-pressure role responsible for managing Missouri In-Home Services (HCBS) billing, EVV compliance, supplemental reimbursements under the Long-Term Care Rebalancing program, and caregiver scheduling. This role requires strong planning, time management, and problem-solving skills, along with the ability to navigate EVV systems and eMOMED to ensure accurate and timely billing and reimbursement.

Key Responsibilities

• Medicaid Billing: Complete monthly billing for services rendered under the Long-Term Care Rebalancing program, ensuring accuracy, timeliness, and compliance with Missouri Medicaid requirements while monitoring billing status through reimbursement.
• EVV Compliance: Ensure full compliance with Missouri EVV requirements for HCBS/In-Home Services by monitoring visit verification, identifying discrepancies, and supporting caregivers with proper EVV usage.
• eMOMED Navigation & Payment Resolution: Utilize eMOMED to review claim activity and address payment issues related to monthly billing and supplemental reimbursements, ensuring alignment between EVV data, billing, and reimbursement outcomes.
• Supplemental Reimbursements: Manage and track supplemental reimbursements under the Long-Term Care Rebalancing program, ensuring required documentation and approvals are completed and following up on payment status.
• Client Coordination & Referrals: Serve as a primary point of contact for clients, families, and caregivers, initiating and following up on HCBS referrals while ensuring timely coordination and documentation.
• PCA Scheduling & On-Call Coverage: Coordinate daily scheduling of caregivers, manage call-offs, emergencies, and last-minute changes, participate in on-call rotation including weekends and after-hours, and ensure appropriate caregiver-to-client matching.

Work Environment & Expectations

This is a fast-paced, high-stress, and reactive environment that requires strong planning and time management skills, the ability to handle frequent interruptions, urgent staffing needs, and consistent interaction with clients, families, and caregivers.

Required Qualifications

Experience with Missouri Medicaid billing, eMOMED system navigation, and EVV systems is required. Candidates should have a background in HCBS/In-Home Services and healthcare scheduling or coordination, along with a strong understanding of Missouri In-Home Services regulations.

Required Certification

Must obtain Designated Manager Certification (In-Home & CDS) within 90 days of hire.

Core Competencies & Traits

Successful candidates will demonstrate exceptional organization and attention to detail, strong communication and empathy, high adaptability and problem-solving skills, strategic matching ability for caregivers and clients, technical proficiency with EVV and eMOMED systems, and strong planning and time management skills.

Additional Application Requirements

• Candidates must provide two (2) professional letters of recommendation from previous supervisors or managers, preferably within healthcare or home care settings.
• Letters must address experience with caregiver scheduling, ability to manage high-stress environments, familiarity with EVV compliance or Medicaid-related processes, and overall reliability, organization, and communication skills.
• Letters must include contact information for verification.
• Letters must be dated within the last 12–24 months.
• Candidates will not be considered without these letters.