Benefits and Eligibility Specialist
About The Position
The Benefits and Eligibility Specialist (BES) makes financial eligibility determinations for Medicaid programs, including ALTCS, SSI MAO, Medicare Savings, KidsCare, Specialty Medicaid, and FTW. The role provides customer service to diverse populations in settings that may include in-person interactions, phone work, and/or a call center. This position is with the Division of Member and Provider Services (DMPS) and is based in Phoenix, Arizona. It offers the flexibility to work remotely full time, though occasional in-office presence may be required based on business or operational needs. Work, including remote work, must be performed within Arizona unless an exception is authorized in advance.
Requirements
- High school diploma or General Equivalency Diploma (G.E.D.).
- At least 6 months of customer service-related work experience.
- Successfully pass a test appropriate to the area of assignment.
- Successfully pass fingerprint background checks, prior employment verifications, and reference checks; employment is contingent upon completion of these processes and the agency’s ability to reasonably accommodate any restrictions.
- Newly hired State employees must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).
- Ability to use computer databases, systems, and programs, including HEAplus, PMMIS, ACE, FORTIS, AZTEC, RightFax, Microsoft applications, email, and word-processing applications.
- Ability to work with minimal supervision and in an inbound automatic call distributor (ACD) environment.
Nice To Haves
- One year of customer service-related work experience.
- Spanish bilingual skills; a plus but not required.
Responsibilities
- Complete financial eligibility determinations for ALTCS, SSI MAO, Medicare Savings, KidsCare, Specialty Medicaid, and FTW programs in accordance with productivity, timeliness, and quality guidelines.
- Schedule and conduct interviews.
- Communicate with customers after interviews, including requesting information, providing status updates, and communicating final decisions.
- Request eligibility verification from multiple sources and review documentation in various systems.
- Research, follow, and apply prescribed policies and procedures.
- Document actions taken, relevant case information, and eligibility-related material in case records throughout the application process until a final determination is made, using the HEAplus system.
- Participate in team meetings and Arizona Management System (AMS) process improvement activities, and assist with special projects.
- Provide customer service in settings that may include in-person interactions, phone work, and/or a call center.
Benefits
- 10 paid holidays per year.
- Paid vacation and sick time off (13 and 12 days per year, respectively); accrual begins on the first day and is prorated for part-time employees.
- Up to 12 weeks per year of paid parental leave for a newborn or newly placed foster or adopted child under a pilot program.
- Bereavement, civic duty, and military leave.
- Retirement program with lifetime pension benefits through the Arizona State Retirement System (ASRS).
- Medical, dental, life, and disability insurance.
- Eligibility to participate in the Public Service Loan Forgiveness Program, subject to qualifications.
- Rideshare and public transit subsidy.
- Learning and career development opportunities.
- Voluntary participation in a tax-deferred Deferred Retirement Compensation Program administered through Nationwide.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
