Medicare & Medicaid Eligibility Specialist, Remote

Centauri Health Solutions • NM

108d

About The Position

The Medicare/Medicaid Eligibility Specialist works with health plan members to determine eligibility for benefits. The Medicare/Medicaid Eligibility Specialist advocates and assists Medicare beneficiaries apply to and requalify for government assistance programs. The Medicare/Medicaid Eligibility Specialist builds trusting relationships with members provide critical application assistance.

Requirements

• Medicare/Medicaid program experience, and experience with screening for Medicaid eligibility a strong plus
• Expertise and knowledge of Medicaid, Special Needs Programs (SNP), Low Income Subsidy (LIS) and the Medicare Savings Program (MSP)
• Strong working knowledge with Microsoft Office programs, and some experience with Excel
• Excellent oral communication skills; ability to communicate with elderly individuals and governmental personnel
• 2-3 years related experience with direct consumer interaction
• Outstanding customer service and communication skills
• Strong organizational, analytical, critical thinking and customer service skills
• Ability to analyze and interpret governmental program criteria
• Ability to manage a fast-paced environment
• Must be able to navigate through multiple databases/monitors with a minimum typing speed of 45 wpm
• Telephone experience and ability to interact and decipher information via telephonic or correspondence inquiries
• Strong subject matter expertise of Medicaid programs regulations and industry standards
• Case management experience or related experience / intermediate
• A compassionate and empathetic nature with a strong desire to help and make a difference

Nice To Haves

• Bachelor’s or Associate’s Degree a plus

Responsibilities

• Conducts telephonic outreach activities for members who need to apply or recertify and are potentially eligible for various Medicaid programs including the Medicare Savings Programs
• Collaborates with government offices to accurately complete the application and recertification process
• Secures documentation for Medicaid/MSP renewal applications if needed for members
• Attention to detail by adhering to state requirements and securing supporting documentation
• Meets daily, weekly, and monthly production goals
• Ensures proper phone etiquette and adherence to scripts, state regulations, HIPAA compliance, and makes accurate and descriptive documentation
• Participates as required in operational development programs
• Research changes with any state and federal regulatory requirements to adhere to strict compliance of all aspects of Medicare programs and Medicaid Outreach Operations
• Demonstrates behaviors, actions, and attitudes that reflect our vision, mission and values
• Understands and agrees to role-specific information security access and responsibilities
• Ensures safety and confidentiality of data and systems by adhering to the organizations information security policies
• Reads, understands and agrees to security policies and completes all annual security and compliance training

Benefits

• Competitive compensation
• Comprehensive benefits package including generous paid time off
• Matching 401(k) program
• Tuition reimbursement
• Annual salary reviews
• Comprehensive health plan
• Opportunity to participate in volunteer activities on company time
• Development opportunities
• Bonus eligible in accordance with the terms of the Company’s plan

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Bachelor's degree
• Number of Employees: 101-250 employees