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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.

Agency

Kentucky → 275 E.Main St.,Fkt, KyView Agency

NAICS

541219 - Other Accounting ServicesView NAICS

Place of Performance

Other, KY, USA

Set-Aside

NONE

Documents

This scope was carved out of RFP 746 2500000254.

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
Organization / Agency
Kentucky → 275 E.Main St.,Fkt, Ky
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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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POSTED

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

Same awarding agency

NAICS: 541611
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RFP-746-2500000254-3 | Financial Mgmt. for PDS in 1915(c)HCBS Waiver Programs C5684
Solicitation # RFP 746 2500000254
The Commonwealth of Kentucky, through the 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. The contract aims to support approximately 15,640 participants by providing essential services including electronic visit verification, claims processing, payroll, tax assistance, and financial reporting. The anticipated start date for the services is February 1, 2027, following a proposal deadline of November 6, 2026. The vendor is required to adhere to strict technical and security standards, including integration with the Kentucky Online Gateway (KOG) for identity and access management and compliance with Commonwealth Office of Technology (COT) requirements. Data security is paramount, with mandates for HIPAA compliance via a Business Associate Agreement and strict adherence to IRS Publication 1075 for handling Federal Tax Information. Performance is monitored through pre-operational and operational report cards, with specific monetary penalties ranging from $100 to $10,000 for non-compliance regarding call center support, billing accuracy, and disaster recovery. Personnel requirements are rigorous, necessitating background checks, vetting by the agency, and professional liability insurance of at least $1 million per claim. The contract emphasizes a structured project management approach following PMI best practices, with key deliverables such as a Project Charter, Work Plan, and Quality Management Plan. All Commonwealth data must remain within the contiguous United States, and the vendor must maintain a high level of financial integrity and accountability to ensure the quality of care and cost neutrality of the waiver programs.
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