Medicaid Eligibility Specialist (Remote)

FreedomCare•Holtsville, NY

4h•$22 - $25•Remote

About The Position

FreedomCare is a healthcare company dedicated to revolutionizing the home care industry. The Medicaid Eligibility Specialist supports patients by facilitating the Medicaid approval process so they can enroll in the company’s programs and receive services. The role also helps current consumers maintain active Medicaid status through recertification and monthly spend-down obligations. It requires attention to detail, strong communication skills, and knowledge of Medicaid policies, regulations, and procedures. The Specialist provides eligibility guidance, manages application and renewal processes, maintains accurate records and Salesforce patient data, and serves as a point of contact for patients, caregivers, health plan partners, healthcare providers, and other stakeholders. The role works across departments and with government agencies to address coverage issues and support patients’ access to Medicaid benefits. This position is for the Pennsylvania team and is remote. The base pay range is $21.84 to $25.00 per hour at the commencement of the first year of employment. Compensation decisions may consider factors including skills, relevant experience, education, location, and licensure or certifications.

Requirements

At least 2 years of experience in Medicaid, healthcare, or social services.
Experience in client support, case management, or benefits coordination.
At least 2 years of understanding of the Medicaid eligibility and application process for Pennsylvania.
Excellent organizational and time management skills.
Proficiency with case management software and other relevant technology.
Strong communication and interpersonal skills, including the ability to work effectively with diverse populations.
Ability to analyze complex information and make informed decisions.

Nice To Haves

Associate’s or Bachelor’s degree in Social Work, Healthcare Administration, Public Health, or a related field preferred.

Responsibilities

Provide clients with information and guidance on Medicaid eligibility requirements and benefits.
Address client inquiries and concerns related to Medicaid applications, renewals, and coverage.
Manage alternative resources to help clients meet Medicaid eligibility requirements.
Conduct client education sessions on Medicaid programs and benefits.
Serve as a subject matter expert on Pennsylvania Medicaid spend-down requirements for clients in pre-care and on-care status.
Monitor and manage Medicaid renewals for existing clients.
Notify clients of upcoming renewal deadlines and help them submit required documentation.
Ensure renewals are processed promptly to avoid lapses in coverage.
Maintain accurate, detailed records of verification processes and outcomes.
Update patient records in Salesforce to reflect current Medicaid status.
Design Medicaid eligibility and spend-down processes and trackability reports in Salesforce.
Serve as a point of contact for Medicaid inquiries from clients, caregivers, and health plan partners.
Help clients understand Medicaid eligibility, benefits, and application processes.
Advocate for clients to ensure they receive appropriate Medicaid services.
Respond to inquiries from patients and healthcare providers about Medicaid coverage and eligibility.
Work with partnering departments to resolve Medicaid coverage and recertification issues.
Assist with training staff on Medicaid verification procedures and policies.
Collaborate with departments, case managers, and other healthcare professionals to support patients’ access to Medicaid benefits.
Identify and resolve issues that may affect clients’ Medicaid eligibility or coverage.
Work with government agencies and other stakeholders to address complex Medicaid-related cases.