Medicaid Specialist - Health Insurance

HealthCare Access Maryland•Baltimore, MD

15d

About The Position

The Medicaid Enrollment Specialist plays a critical role in supporting consumers as they navigate the process of applying for Medicaid, accessing health insurance services through the Maryland Health Connection (MHC). This position provides direct consumer assistance, education, and guidance to individuals seeking Medicaid coverage, ensuring each consumer receives accurate information and a seamless enrollment experience. The specialist is also responsible for managing documentation, system workflows, and maintaining detailed records in compliance with state and organizational requirements.

Requirements

High School Diploma or GED
Demonstrated knowledge in the following areas: Community Outreach and Health Education
Strong computer literacy skills, specifically with MS Word, Excel, Outlook, Powerpoint and SharePoint (365).
Organizational skills with the ability to meet a demanding workload.
Sensitivity to cultural and socioeconomic characteristics of population served.
Excellent oral and written interpersonal and communication skills required.
Problem solving skills.
Proven ability to work efficiently and meet deadlines.
Strong knowledge of community resources

Responsibilities

Assist consumers with completing Medicaid insurance applications through Maryland Health Connection.
Provide one-on-one guidance to help consumers understand eligibility requirements, documentation needs, and enrollment timelines.
Refer consumers to the HCAM Connector Team or other local partner agencies when additional support is required.
Offer system navigation support and education on Health Choice program benefits, MCO options, and next steps after enrollment.
Accept, verify, and upload required consumer documents into the appropriate systems.
Process Verification Check Lists (VCLs), work items, and enrollment transactions within MHC.
Enroll consumers into Managed Care Organizations (MCOs) and process assigned state reports accurately and in a timely manner.
Enter and maintain consumer data across multiple systems while ensuring accuracy, confidentiality, and compliance with state guidelines.
Track daily and weekly productivity metrics for internal and external reporting requirements.
Maintain detailed records of consumer interactions, referrals, and completed tasks to support quality assurance and program evaluation.
Complete referrals and CTAD (Customer Tracking and Data) requests received from internal departments, community partners, or external agencies.
Conduct eligibility outreach activities, including community-based enrollment support, follow-up calls, and targeted outreach to consumers needing assistance.
Attend required staff meetings, trainings, and professional development sessions to remain informed about policy updates, system changes, and best practices.
Collaborate with team members, supervisors, and community partners to provide streamlined, consumer-centered services.
Additional duties as assigned