Medicaid Support Specialist

Conduent • Albuquerque, NM

13d • Remote

About The Position

The Medicaid Support Specialist supports the New Mexico Medicaid Program by providing accurate program information and assisting potential and existing beneficiaries with enrollment and eligibility. The role conducts presentations in the community for groups or individuals, processes eligibility applications, determines eligibility, and enters information into a web-based computer system and relevant New Mexico databases. The specialist follows up with beneficiaries, prepares correspondence, updates files as information is received, and assesses service and information needs. The position reports directly to the Outreach Supervisor and supports successful program administration, inquiry resolution, positive customer experiences, and performance goals.

This role also supports the state-based exchange research process unit and is expected to be an experienced processor and subject matter expert in the systems used for processing. It provides administrative and processing support, including data entry, scanning, mail sorting, and electronic portal, media conversion, content storage, and retrieval tasks. The position is remote for candidates residing within a 50-mile radius of Albuquerque, New Mexico, with occasional office visits if needed. The schedule is Monday through Friday, 8:00 a.m. to 4:30 p.m., with no weekends. The stated pay rate is $16.50 per hour.

Requirements

• Must be at least 18 years of age.
• High school diploma or equivalent education required.
• Must submit to pre-employment screening.
• Must be legally authorized to work permanently in the United States without visa transfer or sponsorship.
• Prior clerical or customer service work experience.
• Comfortable working within established processes and procedures.
• Strong communication and customer service skills.
• Reliable attendance and a strong work ethic.
• Reside within a 50-mile radius of Albuquerque, New Mexico.

Nice To Haves

• Strong problem-solving skills.
• Experience handling escalated customer concerns and complex issues.
• Positive and energetic attitude.
• Ability to communicate clearly and confidently.
• Ability to multitask and manage time effectively.
• Attention to detail and accuracy in grammar and spelling.
• Computer system experience, including data entry and database documentation knowledge.

Responsibilities

• Conduct community presentations about the New Mexico Medicaid Program for groups or individuals.
• Provide accurate information about the program and assist current and potential beneficiaries with enrollment and eligibility.
• Determine eligibility according to New Mexico Medicaid Care regulations and guidelines by reviewing documentation, entering data into a web-based system, and following procedures for automated eligibility rules.
• Prepare correspondence requesting missing information and make outbound calls to obtain, clarify, or validate information.
• Process applications while maintaining an error rate of 5% or below.
• Support the state-based exchange research process unit and serve as a subject matter expert on systems used for processing.
• Follow up with beneficiaries, update files as information is received, and assess service and information needs.
• Assist and train new staff and help in the call center when needed.
• Maintain good attendance and punctuality, work independently on projects, and adhere to policy and procedure changes.
• Build relationships with community members and advocacy groups.
• Provide administrative processing support, including data entry, scanning, mail sorting, and electronic portal, media conversion, content storage, and retrieval tasks.
• Occasionally go into the office if needed.

Benefits

• Medical, dental, and vision benefits from day one for eligible roles.
• PerkSpot employee discount program.
• Paid time off and holidays.
• Paid training.
• Equipment provided.
• Career growth and advancement opportunities.
• Supportive and inclusive work environment.
• Health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off or vacation and/or sick time.
• May be eligible for a bonus or incentive based on business need.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED