Medicaid Eligibility Specialist - REMOTE - KS

Conduent State Healthcare, LLC•Topeka, KS

7d•Remote

About The Position

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day. Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day. As part of the KanCare Clearinghouse Program, the Transaction Processing Associate III (ES) will perform a variety of duties. The position is responsible for gathering thorough documentation and entering information into various systems Essential duties may include, but are not limited to: Analyze the initial applications and reviews (for Family Medical programs) and supporting documentation provided by applicants to determine eligibility for federal and state medical assistance. Investigate the applicant circumstances thorough the use of available computer systems (Databases, registries, and informational deposits) researching records provided by the applicant and their contacts to provide the information about the household income, resources, and expenses upon which the eligibility determination is made. Entering household information and authorizing eligibility within the Kansas Economic and Enforcement System (KEES). Professional completes determinations using State and Federal regulations to determine eligibility for medical benefits based on financial and non-financial criteria. Document the eligibility decision in the electronic case journal and send appropriate system-based and manual correspondence to customers and representatives explaining the results of the eligibility determination and information regarding appeal rights. Eligibility Professionals are expected to use knowledge of State eligibility processes, policies, and procedures governing managed care enrollment to communicate with consumers regarding a variety of issues. Attend training as assigned to develop and enhance current understanding of Kansas Medicaid eligibility programs. Through training and experience, begin to develop expertise in additional areas of determination categories. Maintain with up-to-date knowledge of regulations, policies, and guidelines. Bilingual Spanish/English with the ability to speak and read both languages fluently.

Requirements

Must include a resume when applying
Position is Remote - individual should reside in Kansas
High School diploma or GED equivalent; post-secondary education preferred
Strong computer skills with the ability to maneuver in complex software systems
Requires excellent data entry skills the ability to type 28-30 minutes per minute accurately
MS Office, Outlook, and Internet usage experience

Nice To Haves

Knowledge of Medicaid and managed care programs
Minimum of two (2) years’ experience in determining Long-Term Care, Elderly and Disabled, or Family Medical eligibility
Successfully complete KDHE Eligibility Training and sandboxing
Ability to manage competing priorities
Demonstrated critical thinking skills
Must possess good interpersonal and communication skills both verbally and in writing including knowledge of basic grammar, spelling & punctuation
Willingness to work as part of a team
Maintain the integrity and confidentiality of all records and communications
Bilingual Spanish/English with the ability to speak and read both languages fluently.

Responsibilities

Analyze the initial applications and reviews (for Family Medical programs) and supporting documentation provided by applicants to determine eligibility for federal and state medical assistance.
Investigate the applicant circumstances thorough the use of available computer systems (Databases, registries, and informational deposits) researching records provided by the applicant and their contacts to provide the information about the household income, resources, and expenses upon which the eligibility determination is made.
Entering household information and authorizing eligibility within the Kansas Economic and Enforcement System (KEES).
Professional completes determinations using State and Federal regulations to determine eligibility for medical benefits based on financial and non-financial criteria.
Document the eligibility decision in the electronic case journal and send appropriate system-based and manual correspondence to customers and representatives explaining the results of the eligibility determination and information regarding appeal rights.
Eligibility Professionals are expected to use knowledge of State eligibility processes, policies, and procedures governing managed care enrollment to communicate with consumers regarding a variety of issues.
Attend training as assigned to develop and enhance current understanding of Kansas Medicaid eligibility programs.
Through training and experience, begin to develop expertise in additional areas of determination categories.
Maintain with up-to-date knowledge of regulations, policies, and guidelines.
All other duties as assigned.

Benefits

Health benefits (medical, dental, vision) are available on the first day of employment.
Paid time off is accrued after 180 days (about 6 months) of employment.

Stand Out From the Crowd

Upload your resume and get instant feedback on how well it matches this job.

Upload and Match Resume