The Medicaid Eligibility Specialist assists clients with the Medicaid application and approval process by providing guidance, gathering required documentation, completing applications, and monitoring application status. This position serves as a resource for clients, helping them navigate eligibility requirements and ensuring timely submission of necessary information to support Medicaid approvals.
Education:
- High School Diploma or equivalent
Work Experiences:
- At least 2 years of experience in a healthcare setting.
Responsibilities:
- Meet with clients to explain Medicaid eligibility requirements and application processes.
- Assist clients in completing Medicaid applications accurately and thoroughly.
- Collect, review, and organize required documentation needed to support Medicaid eligibility determinations.
- Follow up with clients regarding missing information or documentation.
- Track application status and assist clients with responding to requests for additional information.
- Maintain accurate and up-to-date client records in accordance with organizational policies and confidentiality requirements.
- Communicate with government agencies, healthcare providers, and other relevant parties as needed to support the application process.
- Educate clients on Medicaid benefits, coverage options, and renewal requirements.
- Assist clients with Medicaid redeterminations, renewals, and related eligibility matters.
- Stay informed of changes to Medicaid guidelines, regulations, and processes.
- Provide exceptional customer service while maintaining professionalism and compassion when working with clients and families.
- Participate in team meetings, training, and other organizational activities as assigned.
- Promote a client-centered culture across all programs and departments.
- Provide actionable insights and recommendations for leadership.
- Partner with clinical and operational teams to improve client experience.
- Promote healthy communication with community stakeholders, intra and interdepartmental relationships.
- Ensure consistency in service delivery standards across locations and service lines
- including but not limited to the Department of Mental Health-Mental Health Program and Core Rule certification standards, CARF accreditation standards, and Center and Program processes, policies, and procedures.
- Perform specific administrative tasks as determined by the executive team.
- Perform all other duties as assigned.
Physical Requirements:
- Normal office environment.
- Typical demands include prolonged sitting, frequent standing, bending, stooping, and occasional lifting.
- Requires normal range of hearing and manual dexterity sufficient to operate keyboard, telephone, photocopier, calculator, and other office equipment as needed.
- Requires the ability to remain calm during stressful events, to occasionally work irregular hours, and work with exasperated individuals.
- Occasional lifting to 50 pounds
- Occasional travel required
