Remote Bilingual Medicare & Medicaid Eligibility Specialist (Advocate)
About The Position
Centauri Health Solutions is seeking a bilingual Medicare/Medicaid Eligibility Specialist to guide members applying for or obtaining or retaining Medicaid, Medicare Savings Programs (MSP), and Low-Income Subsidies (LIS). This phone-based advocacy role involves making and receiving calls, assessing potential eligibility through questions, explaining complex regulations in clear and patient terms, and gathering and verifying sensitive personal and financial information for accurate enrollment and recertification. The specialist must follow HIPAA, state regulations, and company compliance standards while navigating multiple software systems and databases to document member progress. The position operates 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
- Fluency in Spanish, including speaking, reading, and writing.
- Two to three 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, show patience, and build trust when facing obstacles.
- Ability to manage difficult conversations and use probing questions to clarify information and find solutions.
- Willingness to work in a high-volume, phone-based role and follow structured procedures.
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).
- Determine whether individuals may be eligible for Medicaid or LIS by asking a series of questions.
- Explain regulations and eligibility requirements in simple, patient terms when needed.
- Gather and verify sensitive personal and financial information for accurate enrollment and recertification.
- Comply with HIPAA, state regulations, and company 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
- Company-paid basic life and AD&D insurance
- 401(k) plan with company match
- Tuition reimbursement
- 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
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
