Medicaid Eligibility Specialist

Conduent•Remote, KS

1d•$17•Remote

About The Position

As part of the KanCare Clearinghouse Program, the Medicaid Eligibility Specialist will perform a variety of duties. The position is responsible for gathering thorough documentation and entering information into various systems. This position is remote and requires the individual to reside in Kansas. The start date is tentatively August 10th, and the hours are 8:00 am - 4:30 pm CST. Training will last approximately 10 weeks, including sandboxing.

Requirements

High School diploma or GED equivalent
Strong computer skills with the ability to maneuver in complex software systems
Excellent data entry skills with the ability to type 28-30 words per minute accurately
MS Office, Outlook, and Internet usage experience
Must reside in Kansas

Nice To Haves

Post-secondary education preferred
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
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 initial applications and reviews (for Family Medical programs) and supporting documentation provided by applicants to determine eligibility for federal and state medical assistance.
Investigate applicant circumstances through the use of available computer systems (Databases, registries, and informational deposits), researching records provided by the applicant and their contacts to provide information about household income, resources, and expenses upon which the eligibility determination is made.
Enter household information and authorize eligibility within the Kansas Economic and Enforcement System (KEES).
Complete 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.
Make outbound calls, based on established policy, to verify or obtain missing information when documentation is incomplete and the information can be resolved via telephone contact.
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.
Develop expertise in additional areas of determination categories through training and experience.
Maintain up-to-date knowledge of regulations, policies, and guidelines.
Perform other duties as assigned.