Medicaid Eligibility Specialist

Job Description:

• Provide clients with information and guidance on Medicaid eligibility requirements and benefits
• Address client inquiries and concerns related to Medicaid applications, renewals, and coverage
• Manage alternative resources for clients to meet Medicaid eligibility requirements
• Conduct client education sessions on Medicaid programs and benefits
• Serve as a subject matter expert on Pennsylvania Medicaid spenddown requirements through clients' pre-care and on-care status
• Monitor and manage the Medicaid renewal process for existing clients
• Notify clients of upcoming renewal deadlines and assist with required documentation
• Ensure renewals are processed timely to avoid lapses in coverage
• Maintain accurate records of verification processes and outcomes
• Update patient records in Salesforce to reflect current Medicaid status
• Design Medicaid eligibility and spenddown processes and trackability reports in Salesforce
• Serve as a point of contact for Medicaid inquiries from clients, caregivers, and health plan partners
• Assist clients in understanding Medicaid eligibility, benefits, and application processes
• Advocate for clients to ensure they receive appropriate Medicaid services
• Respond to inquiries from patients and healthcare providers regarding Medicaid coverage and eligibility
• Collaborate with partnering departments, case managers, and healthcare professionals to support patient access to Medicaid benefits
• Assist with training staff members on Medicaid verification procedures and policies
• Identify and resolve issues affecting clients' Medicaid eligibility or coverage
• Work with government agencies and stakeholders to resolve complex Medicaid-related cases

Requirements:

• Associate's or Bachelor's degree in Social Work, Healthcare Administration, Public Health, or a related field preferred
• Minimum of 2 years of experience in Medicaid, healthcare, or social services
• Experience in client support, case management, or benefits coordination
• Minimum of 2 years of understanding of the Medicaid eligibility and application process for the state of Pennsylvania
• Excellent organizational and time management skills
• Proficient in using case management software and other relevant technology
• Strong communication and interpersonal skills, with the ability to work effectively with diverse populations
• Ability to analyze complex information and make informed decisions

Benefits:

• Competitive compensation
• Medical benefits
• Retirement plans
• Wellness programs
• Fun company events
• Ongoing learning opportunities to grow your career
• Inclusive environment
• Equal Opportunity Employer

Apply To This Job