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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.

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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Same NAICS industry code

NAICS: 541219
New
Federal
Request for Information (RFI) – Financial Reporting & Accounting
Solicitation # HHM402-27-X-FRAS
The Virginia Contracting Activity (VaCA) has issued a Sources Sought Notice and Request for Information (RFI) under solicitation HHM402-27-X-FRAS to identify potential sources capable of providing financial accounting and reporting support for the Defense Intelligence Agency (DIA) Office of the Comptroller (CFOCO). The scope of work involves comprehensive general ledger management, transaction validation, account reconciliation, and asset accounting, including depreciation, amortization, and lease accounting. The contractor will be required to utilize the FACTS (Oracle PeopleSoft) system and ensure all outputs, such as Agency Financial Reports and quarterly financial statements, comply with OMB Circular A-136, the DoD Financial Management Regulation, and U.S. Standard General Ledger standards. The anticipated contract structure consists of a 12-month base period followed by four 12-month option periods, with the primary place of performance located at DIA Headquarters in Washington, DC. Due to the nature of the work, personnel must possess TS/SCI clearances with CI Polygraphs. Performance will be monitored via a Quality Assurance Surveillance Plan, with high accuracy thresholds required for financial reporting packages and posting logic. Interested small and large businesses must submit their capability responses, limited to 20 pages, via email to the designated points of contact no later than October 23, 2026, at 4:00 PM ET.
Virginia Contracting Activity

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1 day ago

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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
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. The selected vendor will provide comprehensive financial operations for approximately 15,640 participants, including payroll processing at least twice per month, electronic visit verification, claims processing, tax assistance, and detailed financial reporting. The anticipated contract start date is February 1, 2027, with proposals due by November 6, 2026. Technical requirements mandate 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 comply with Commonwealth Office of Technology standards, including FedRAMP/HITRUST certification for cloud platforms and strict data residency within the contiguous United States. Security is paramount, requiring a Business Associate Agreement for HIPAA compliance and immediate notification of data breaches within 30 minutes. The contract includes a rigorous performance monitoring system utilizing 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. Evaluation is based on a point system consisting of a technical proposal (800 points), a cost proposal (300 points), and potential oral demonstrations (200 points). Technical qualification requires proof of being a licensed entity for at least five years and the ability to maintain staffing levels at 90 percent or more of the agreed-upon plan. Cost proposals must specify a rate per member per month and a monthly administrative cost, noting that travel and training expenses are not reimbursable. Additionally, the contractor must maintain cyber insurance or a performance bond for the full contract amount to cover liabilities related to cybersecurity breaches and data loss.
Administrative Management and General Management Consulting Services

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3 months ago

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in 20 days
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