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Medicaid Claims and Invoice Processing Specialist

Active
State & Local

Contract Overview

Solicitation details, issuing organization, response deadlines, documents, and interested companies for this government contract opportunity.

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This subcontract for a Medicaid Claims and Invoice Processing Specialist involves managing neutral bank functions for prime contractors on Commonwealth of Kentucky Medicaid projects. The selected provider will be responsible for processing claims and invoices for goods and services, tracking participant budget funds, and preparing detailed expenditure reports. All financial activities must be conducted using specialized accounting software and claims management systems in strict accordance with GAAP and Medicaid fiscal agent standards. The contract requires the delivery of processed invoices, budget reports, and comprehensive financial statements. This opportunity is associated with the state of Kentucky and is categorized under NAICS code 541219. Interested parties must submit their responses by the deadline of November 6, 2026.

General Info

Kentucky Medicaid subcontract for claims and invoice processing; responses due November 6, 2026.

Place of Performance

Other, KY, USA

Set-Aside

NONE

Documents

This scope was carved out of RFP-746-2500000254-3.

The full solicitation package (11 documents), including the RFP, is on the prime solicitation, not on this scope.

View the prime solicitation

RFP-746-2500000254-3 | Financial Mgmt. for PDS in 1915(c)HCBS Waiver Programs C5684

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Organization & Contact Information

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AgencyKentucky → 275 E.Main St.,Fkt, Ky
ContactsNo contacts available
OfficeN/A
Office AddressN/A
ContactsNo contact information available

Full Description

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Manages neutral bank functions for prime contractors on Commonwealth of Kentucky Medicaid projects. Processes claims and goods/services invoices, tracks participant budget funds, and prepares expenditure reports. Uses financial accounting software and claims management systems per GAAP and Medicaid fiscal agent standards. Delivers processed invoices, budget reports, and financial statements.

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More opportunities from Kentucky → 275 E.Main St.,Fkt, Ky

Same awarding agency

NAICS: 541611
SLED
RFP-746-2500000254-3 | Financial Mgmt. for PDS in 1915(c)HCBS Waiver Programs C5684
Solicitation # RFP-746-2500000254-3
The Commonwealth of Kentucky Cabinet for Health and Family Services, Department for Medicaid Services, is soliciting proposals for Financial Management Services (FMS) to support Participant-Directed Services (PDS) across five 1915(c) Medicaid waiver programs: Acquired Brain Injury, ABI Long Term Care, Home and Community Based, Michelle P. Waiver, and Supports for Community Living. Serving approximately 15,640 participants, the selected vendor will be responsible for critical financial operations, including payroll processing at least twice per month, claims processing, electronic visit verification, tax assistance, and comprehensive financial reporting. The contract requires strict adherence to PMI project management standards and integration with the Kentucky Online Gateway for identity and access management using SAML 2.0, OIDC/OAuth 2.0, or WS-Fed protocols. Vendors must demonstrate at least five years of business licensure and the financial capability to serve all current and future participants across Kentucky. Technical requirements include compliance with Commonwealth Office of Technology standards, HIPAA and HITECH Act regulations via a Business Associate Agreement, and the maintenance of cyber insurance or a full-value performance bond. Performance is monitored through pre-operational and operational report cards, with monetary penalties ranging from $100 to $10,000 for non-compliance in areas such as call center support, billing accuracy, and disaster recovery. Proposals are evaluated based on a point system weighing the technical proposal at 800 points, the cost proposal at 300 points, and potential oral demonstrations at 200 points.
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