Medicaid Specialist Resume Example & Writing Guide

Use this Medicaid Specialist resume example and guide to improve your career and write a powerful resume that will separate you from the competition.

If you enjoy helping people and thrive in a collaborative environment, consider becoming a Medicaid specialist. Medicaid specialists are responsible for managing their agency’s Medicaid program, which provides health insurance coverage for low-income individuals and families. They’re often on the front lines of the healthcare system, interacting with patients and families to help them access the services they need.

To land your dream job as a Medicaid specialist, it’s important to have a resume that highlights your relevant experience and skills. Here are some tips and an example to help you write yours.

Michael Garcia
Phoenix, AZ | (123) 456-7891 | [email protected]

Experienced Medicaid specialist with a passion for helping people. Proven ability to navigate complex systems, assess client needs, and provide quality customer service. Skilled at collaborating with cross-functional teams to deliver results.

Northern Arizona University Jun '10
B.S. in Business Administration
Company A, Medicaid Specialist Jan '17 – Current
  • Provided customer service and assisted with the development of new Medicaid plans for existing clients as well as marketing efforts to attract new business.
  • Managed a team of 5 caseworkers, including hiring, training, coaching, performance management, and termination/discipline when appropriate.
  • Developed and implemented policies and procedures that ensured compliance with all applicable laws and regulations related to Medicaid eligibility determination processes.
  • Assisted in developing budgets for assigned accounts based on projected revenue growth or decline within each account.
  • Participated in sales meetings to provide information regarding current market conditions affecting the company’s ability to grow its business in specific markets or regions where it operates.
Company B, Medicaid Specialist Jan '12 – Dec '16
  • Created and maintained a comprehensive database of Medicaid recipients, including eligibility requirements, benefits and contact information
  • Assisted in the development of an automated system for tracking client data that increased productivity by 25%
  • Conducted outreach to clients who were eligible for additional services or programs available through Medicaid
  • Collaborated with other departments to ensure all clients received appropriate care regardless of their ability to pay
  • Provided counseling on how to apply for Medicaid coverage as well as applying it personally when needed
Company C, Medicaid Eligibility Specialist Jan '09 – Dec '11
  • Verified applicant information and documentation to determine Medicaid eligibility in accordance with state and federal guidelines.
  • Communicated with applicants regarding status of their applications and next steps in the process.
  • Maintained detailed records of eligibility determinations and caseload status.
  • Arizona Department of Economic Security License
  • Medicaid Specialist Certification

Industry Knowledge: HIPAA, CPT, ICD-10, CPT-4, Medicare, Medicaid
Technical Skills: Epic, Cerner, McKesson, Allscripts, Meditech, Microsoft Office Suite
Soft Skills: Critical Thinking, Problem-Solving, Decision-Making, Teamwork, Communication, Empathy, Leadership

How to Write a Medicaid Specialist Resume

Here’s how to write a medicaid specialist resume of your own.

Write Compelling Bullet Points

The best way to make your resume stand out is to use specific examples and numbers. So rather than saying you “managed Medicaid claims,” you could say that you “managed Medicaid claims for 200+ patients, resulting in a 98% approval rate.”

The second bullet point is much stronger because it provides specific details about what you did and the results of your work. And it also includes a quantifiable result (98% approval rate).

Identify and Include Relevant Keywords

When you apply for a Medicaid specialist role, your resume is likely to go through an applicant tracking system (ATS). This software looks for certain keywords related to the job in order to determine whether you are a good fit. If your resume doesn’t include enough of the right terms, the ATS might automatically reject your application.

To increase your chances of getting an interview, make sure to include keywords throughout all sections of your resume. Here are some commonly used Medicaid specialist keywords:

  • Medicaid
  • Working with Medicaid
  • Medicare
  • Claims Processing
  • Healthcare
  • Benefits Management
  • Medical Billing
  • Managed Care
  • U.S. Health Insurance Portability and Accountability Act (HIPAA)
  • Hospitals
  • Account Reconciliation
  • Health Insurance
  • Electronic Medical Record (EMR)
  • Life Insurance
  • Patient Access
  • Healthcare Management
  • Electronic Data Interchange (EDI)
  • Medical Coding
  • Long-term Care
  • Medicare Advantage
  • Medicaid Eligibility
  • Government Programs
  • Disability Insurance
  • Health Policy
  • Nursing
  • Healthcare Reform
  • Claim Appeals
  • Health Insurance Portability and Accountability Act (HIPAA)
  • Data Entry
  • Accounts Receivable (AR)

Showcase Your Technical Skills

As a Medicaid specialist, you need to be proficient in a number of software programs and systems in order to do your job effectively. This might include familiarity with Medicaid management software, Medicaid eligibility software, and Medicaid claims processing software. Additionally, you need to be able to use technology to communicate with other members of the healthcare team, including doctors, nurses, and other specialists.

Some of the programs and systems that Medicaid specialists are typically expected to be proficient in include: Medicaid management software, Medicaid eligibility software, Medicaid claims processing software, and electronic health records (EHR) software.


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