Medicaid Product Specialist

CAI•Newark, DE

7d•Onsite

About The Position

CAI is seeking a Medicaid Product Specialist to enter Medicaid renewal applications into the eligibility system and ensure applications are complete and accurate. The role also supports client onboarding and eligibility determinations through intake assessments, interviews, document collection, financial analysis, and case management. The position is full-time and on-site in Newark, Delaware. The specialist must follow CAI and State security protocols and compliance requirements and remain informed about applicable Federal and State laws, Medicaid regulations, standards, and policies.

Requirements

High school diploma or equivalent.
At least one year of data entry experience.
At least one year of customer service experience.
Proficiency in Microsoft Office Suite, including Word, Excel, and Outlook.
Strong organizational skills and attention to detail.
Ability to perform and analyze financial calculations accurately.
Strong problem-solving skills and ability to synthesize data from multiple sources to inform decisions.
Analytical ability to evaluate complex issues and identify patterns, trends, or root causes.
Excellent written and verbal communication skills; fluency in English is required.
Self-motivated and dependable, with a commitment to community impact and collaboration in a team-oriented environment.
Reliable transportation to and from the office and punctual attendance.
Availability to work full-time on-site, including occasional Saturdays at least once per month if necessary.
Ability to remain seated for extended periods and perform desk-based tasks.

Nice To Haves

Familiarity with Medicaid or other public assistance program eligibility requirements.
Bilingual communication skills with strong written proficiency.

Responsibilities

Enter Medicaid renewal applications into the eligibility system, ensuring quality and accuracy.
Acquire and maintain knowledge of Federal and State laws, Medicaid regulations, standards, and State policies governing public assistance programs.
Follow CAI and State security protocols and compliance requirements.
Use computer inquiry systems to retrieve verification documents and information.
Conduct intake assessments to evaluate Medicaid eligibility for new clients.
Process Medicaid renewal applications for clients renewing medical benefits.
Analyze financial data and perform calculations for accurate entry into the eligibility system.
Interview clients to obtain and exchange sensitive information needed for eligibility determinations.
Work with clients to securely collect application documents in digital formats such as PDF and JPG.
Maintain detailed case management records and documentation in the eligibility system.
Act as a witness at fair hearings for clients appealing eligibility determinations, as necessary.
Participate in individual and team meetings to stay current on processes, procedures, and policy changes.
Perform additional case management tasks as required to support program goals.