Remote Medicare & Medicaid Eligibility Specialist (Advocate)

Centauri Health Solutions

13d • Remote

About The Position

Centauri Health Solutions is hiring Medicare/Medicaid Eligibility Specialists to advocate for members navigating government benefits. Specialists make and receive calls with members who need to apply for, obtain, or retain Medicaid, Medicare Savings Programs (MSP), and Low-Income Subsidies (LIS). They determine potential eligibility through questions and explain complex regulations and requirements in clear, patient terms.

The role involves collecting and verifying sensitive personal and financial information for accurate enrollment and recertification, complying with HIPAA, state regulations, and company standards, and navigating multiple software systems and databases to document and track member progress. This is a high-volume, phone-based position in a structured, performance-driven environment, with defined procedures and daily and weekly production and quality goals. The schedule is Monday through Friday, 11:00 a.m. to 7:30 p.m. EST (9:00 a.m. to 5:30 p.m. MST).

Requirements

• 2–3 years of experience in healthcare, eligibility screening, case management, or high-touch customer service.
• Comfort navigating multiple screens and using Microsoft Teams and Outlook while talking and typing and documenting information in real time.
• Ability to remain calm and professional when facing obstacles.
• Ability to manage difficult conversations and use probing questions to clarify information and find solutions.

Nice To Haves

• Knowledge of Medicaid, Medicare, SCHIP, or Special Needs Plans (SNP).

Responsibilities

• Make and receive calls with members seeking to apply for, obtain, or retain Medicaid, Medicare Savings Programs (MSP), and Low-Income Subsidies (LIS).
• Ask questions to determine potential Medicaid or LIS eligibility.
• Explain complex regulations and eligibility requirements in clear, patient terms.
• Gather and verify sensitive personal and financial details for enrollment and recertification.
• Follow HIPAA, state regulations, and company compliance standards.
• Navigate multiple software systems and databases to track member progress and documentation.
• Meet daily and weekly production and quality goals.

Benefits

• Comprehensive medical, dental, vision, and prescription coverage.
• Wellness program supporting overall well-being.
• Company-paid basic life and AD&D insurance.
• 401(k) plan with company match.
• Tuition reimbursement opportunities.
• Paid time off for vacation and illness.
• Six paid company holidays.
• Floating holiday.
• Company-paid training and computer equipment.
• Performance-based bonus program.
• Paid time off for volunteer activities.
• Employee referral bonus program.
• Career development and training opportunities, including leadership growth.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed