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  

• TB test upon hire.