Family & Children Medicaid - Eligibility Caseworker I
About The Position
The Eligibility Caseworker I – Family & Children’s Medicaid (FCMA) works in Wake County’s Economic Services Division to provide timely and accurate Medicaid benefits and help clients access essential resources. The position interviews individuals by phone or in person, evaluates financial and personal information, determines eligibility, assists with economic benefits and community referrals, and processes applications, redeterminations, and reviews. The caseworker maintains case documentation, uses NCFAST and document management systems for case tracking and accuracy, provides backup support to fellow caseworkers, and manages reports. The role calls for someone who can interpret complex policies, calculate and analyze client budgets, assess financial information, maintain accuracy and objectivity, and deliver strong customer service. It requires resilience in a fast-paced environment, clear written and verbal communication, effective interpersonal skills, respect for diverse perspectives, and proficiency with office software and systems. This is a regular position located at Wake Medical Center in Raleigh, North Carolina. The work schedule is Monday through Friday, 8:00 a.m. to 4:30 p.m. The hiring range is 26.07–29.81, and the market range is 26.07–33.55. In emergencies, the employee may be assigned different duties, hours, or work locations and may be required to participate in preparedness training and exercises. The position may require a background check.
Requirements
- High school degree or GED.
- Two years of related experience; equivalent education and experience are accepted.
- Ability to interpret complex policies and translate them into client budgets.
- Ability to calculate and analyze budgets and review and assess financial information.
- Strong attention to detail, integrity, objectivity, and resilience under pressure.
- Commitment to diversity and strong client and customer service.
- Effective written, verbal, and interpersonal communication skills.
- Proficiency with office software and systems, including Microsoft Office, NC FAST, and Hyland OnBase.
- Applicants should include all prior work experience on their application and resume.
Nice To Haves
- Experience determining eligibility for a State or County Department of Social Services program, such as Medicaid, Food and Nutrition Services, Work First, Child Care Subsidy, Child Support, WIC, Energy Assistance, or services in a homeless setting.
- Experience as a Human Services Technician supporting a human services program in a county or state Department of Human Services or Social Services agency.
- Experience determining eligibility for a financial or insurance provider, handling financial assistance or insurance claims, assessing financial capability and need for assistance, or providing financial counseling.
- Experience providing direct clerical or customer service support to an Economic Services Program within a State or County Department of Social Services.
- Spanish language skills.
- Experience working in a hospital setting.
Responsibilities
- Interview individuals by phone or in person to assess Medicaid eligibility.
- Evaluate financial and personal information and make eligibility determinations.
- Assist clients with economic benefits, community referrals, and other resources.
- Process applications and redeterminations, conduct reviews, and maintain case documentation.
- Use NCFAST and document management systems for case tracking and accuracy.
- Provide backup support to fellow caseworkers and manage reports.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
