Medicaid Eligibility Specialist I

This is a fully remote position, open to applicants in United States.

📋 Description

• Acquire a comprehensive understanding of FSSA programs, their benefits, eligibility criteria, and enrollment procedures.

• Act as the subject matter expert for inquiries related to Medicaid eligibility.

• Verify patient eligibility for Medicaid benefits utilizing online systems and tools.

• Assist patients in conducting a preliminary review of Medicaid application documentation and requirements.

• Confirm coverage specifics and ascertain patient benefits based on Medicaid guidelines.

• Investigate issues related to eligibility, deferrals, denials, and recertifications, and propose suitable resolutions.

• Maintain precise records of verification processes and their outcomes.

• Update patient records in Salesforce with the current Medicaid status.

• Respond to Medicaid inquiries from clients, caregivers, health plan partners, patients, and healthcare providers.

• Clarify Medicaid eligibility, benefits, and application processes to stakeholders.

• Advocate for clients to ensure they receive the necessary Medicaid services.

• Collaborate with various departments, case managers, and healthcare professionals to facilitate patient access to benefits.

• Assist in training staff on Medicaid verification procedures and policies.

⛳️ Requirements

• A minimum of 2 years of experience in healthcare, insurance verification, or a related field is required.

• An associate degree or higher in healthcare administration, business, or a related field is preferred.

• Experience with Medicaid verification and a strong understanding of Medicaid regulations is highly preferred.

• A strong customer focus and the ability to adapt in a high call volume environment are essential.

• Excellent customer service skills, including empathy, active listening, and patience.

• Proficient written and verbal communication skills suitable for diverse audiences.

• Ability to multitask, prioritize, and manage time effectively.

• Technical proficiency in navigating multiple systems while ensuring data accuracy.

• Familiarity with role-specific tools and resources, with a significant reliance on Excel.

• Ability to embrace change and support departmental growth in a dynamic environment.

🏝️ Benefits

• Competitive compensation.

• Medical benefits.

• Retirement plans.

• Wellness programs.

• Engaging company events.

• Continuous learning opportunities to advance your career.

• Remote work arrangements.

• Equal Opportunity Employer with an inclusive environment.