Eligibility Specialist III

Forsyth County • Winston-Salem, NC

18h • Onsite

About The Position

The Department of Social Services seeks a dependable professional to provide on-site assistance at a partnering hospital to individuals and families seeking Medicaid benefits. The position accepts, reviews, and processes Family and Children’s Medicaid (FCMA) and Adult Medicaid applications. The specialist interprets complex Medicaid rules and regulations, exercises sound judgment in making eligibility decisions, and works independently in a fast-paced hospital setting while coordinating with the Department of Social Services to ensure timely and accurate determinations. The role requires strong communication, customer service, organizational, and time-management skills, as well as flexibility, professionalism, accountability, and the ability to work collaboratively with customers and partners from diverse backgrounds. Attendance at state and local trainings regarding program requirements is required.

Requirements

• High school graduation or GED.
• Two years of experience as an Eligibility Specialist or in closely related work; a higher education level may substitute for all or part of the experience requirement.
• Excellent verbal and written communication skills.
• Ability to interpret complex Medicaid rules and regulations and make appropriate eligibility decisions.
• Ability to perform basic mathematical calculations.
• Strong organizational and time-management skills, including the ability to work within established deadlines.
• Proficiency with computer technology and general office equipment.
• Ability to work independently and collaboratively in a fast-paced, evolving, customer-focused hospital environment.
• Strong interpersonal skills and adaptability.
• Ability to communicate with customers from diverse backgrounds.

Nice To Haves

• Commitment to the WeCare principles of Integrity, Awareness, Accountability, Respect, and Excellence.
• Strong organizational skills, flexibility, professionalism, and accountability.

Responsibilities

• Conduct applicant interviews.
• Gather and verify required documentation.
• Determine eligibility in accordance with federal and state Medicaid policies.
• Accept, review, and process Family and Children’s Medicaid (FCMA) and Adult Medicaid applications within established timeframes.
• Respond to inquiries from applicants, hospital personnel, and community partners.
• Work independently in a hospital setting while maintaining effective communication and coordination with the Department of Social Services.
• Attend state and local trainings regarding program requirements.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED