Eligibility Specialist I - ADULT MEDICAID

County of Mecklenburg, NC•Charlotte, NC

4d•$20 - $23•Onsite

About The Position

Under direct supervision, this position performs customer service activities and determines initial and ongoing eligibility for the Adult Medicaid (AMED) program. The AMED program administered by the Department of Community Resources, provides healthcare coverage to eligible low-income adults, including seniors, individuals with disabilities, and those requiring long-term care. The program ensures access to vital medical services such as doctor visits, hospital care, prescriptions, and private living assistance. The program focuses on improving the well-being of vulnerable populations by determining eligibility, guiding individuals through the application and redeterminations process, and connecting them with essential healthcare resources. For more information, please visit the State and County program sites below: State Information site: https://medicaid.ncdhhs.gov/ State AMED Policy Manual: https://policies.ncdhhs.gov/divisional-a-m/health-benefits-nc-medicaid/adult-medicaid/ County Resource site: https://dcr.mecknc.gov/Medicaid

Requirements

Minimum of two years of experience in customer service with direct interaction with members of the public or successful completion of the CPCC Caseworker Training Program (or another participating program).
High School Diploma or equivalent
May require a valid North Carolina or South Carolina Driver's License.
Knowledge of principles and processes for providing customer and personal services, including customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar
Modern office practices, procedures, and equipment
Familiar with social service programs
Active Listening: Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate
Service Orientation; actively looking for ways to help people
Being aware of others' reactions and understanding why they react as they do
Talking to others to convey information effectively
Communicating effectively in writing as appropriate for the needs of the audience
Communication: Clearly conveying information and ideas through a variety of media to individuals or groups in a manner that engages the audience and helps them understand and retain the information provided
Continuous Learning / Applied Learning: Actively identifying new areas for learning; regularly creating and taking advantage of learning opportunities; using newly gained knowledge and skill on the job and learning through their application
Contributing to Team Success / Collaboration: Actively participating as a member of a team to move the team toward the completion of goals; working effectively and cooperatively with others; establishing and maintaining good working relationships
Customer Focus: Ensuring that the customer perspective is a driving force behind business decisions and activities; crafting and implementing service practices that meet customers’ and own organization’s needs
Energy / Inspiring Others: Using interpersonal styles and methods to inspire and guide individuals toward higher levels of performance
Ethical Decision Making: Identifying and understanding issues, problems, and opportunities comparing data from different sources to draw conclusions, using effective approaches for choosing a course of action or developing appropriate solutions; taking action that is consistent with available facts, constraints, and probable consequences
Managing Work: Effectively managing one’s time and resources to ensure that work is completed efficiently
Motivation Fit: The extent to which activities and responsibilities available in the job and the organization’s mode of operation and values provide personal satisfaction
Proficient in various computer applications including Microsoft Office Suite.

Nice To Haves

Associate or Bachelor’s degree preferred
Experience processing insurance claims, mortgage/loan processing, working with specialized computer programs and working in a call center preferred
Bilingual (Spanish and English) proficiency oral and written

Responsibilities

Assist call center or walk-in contacts, interview customers, gather information, and input data into appropriate systems
Verify customer’s information through paper documentation, on-line search and phone calls and determines program eligibility
Process applications for single program basic benefits
Respond to client and public inquiries regarding services available, documentation requirements, other community resource options, and on-going program and benefit status and customer record changes
Perform data entry and maintains system files and databases on clients, providers, and program services
Maintain basic knowledge of multiple social services programs or in-depth knowledge in one program
Perform work in a high volume, fast-paced environment with continual customer interaction
Some positions may be required to directly work on enrollment and eligibility activities within the NC FAST system
May be required to staff shelters in the event of a disaster

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