Eligibility County Coordinator

Conduent•Hamilton Township, NJ

7h•$20 - $23•Hybrid

About The Position

Reports directly to the Eligibility Health Benefit Coordinator Supervisor. Processes eligibility applications and determines eligibility for the NJ Family Care program and refers to beneficiaries who are potentially eligible for Medicaid to DMAHS for review. Enters eligibility information into a web-based computer system and references other NJ-specific databases as appropriate. Follows up with beneficiaries with correspondence, performs file updates as information comes in, and assesses service/information. Acts as a liaison between the county offices and Conduent.

Requirements

High School Diploma required; Associate degree preferred.
2+ years of customer service experience in healthcare preferred.
Experience processing detailed information and following established procedures.
Public assistance or eligibility determination experience is strongly preferred.
Working knowledge of Medicaid, managed care, and public assistance eligibility programs.
Strong data entry, analytical, and information gathering skills with attention to detail and accuracy.
Ability to interpret and apply policies, procedures, and eligibility requirements.
Strong problem-solving and decision-making skills, including basic math calculations for eligibility determinations.
Excellent verbal, written, and interpersonal communication skills.
Ability to build effective relationships with beneficiaries, colleagues, and community partners.
Strong organizational skills with the ability to multitask, meet deadlines, and perform effectively under pressure.
Ability to maintain confidentiality, exercise sound judgment, and work independently.
Proficiency in Microsoft Office and web-based systems.

Nice To Haves

Bilingual skills are a plus.

Responsibilities

Review and verify application information and support documentation for accuracy, completeness, and compliance with NJ Family Care guidelines.
Identify, document, and follow up on missing information; process updates and correspondence as required.
Determine eligibility for NJ Family Care using established policies, procedures, and automated eligibility systems.
Enter, maintain, and update eligibility, renewal, and status-change information in web-based systems.
Verify beneficiary information, investigate discrepancies, and contact applicants as needed to obtain or clarify required information.
Refer potentially Medicaid-eligible beneficiaries to DMAHS and route cases for supervisory review when required.
Support enrollment operations by handling inbound and outbound calls with beneficiaries and county offices.
Participate in quality improvement initiatives, training programs, and ongoing process enhancements.
Report technical issues promptly and perform additional duties as assigned.