Eligibility Specialist III

Forsyth-County,-Nc; East Winston (NC); On-site; USD 42,000 - 65,000; Full time

Job summary

The Department of Social Services is seeking qualified Eligibility Specialists to provide on-site support at partnering hospitals for Medicaid applications (FCMA and Adult Medicaid). You will interview applicants, review documents, and determine eligibility in line with federal and state policies while meeting strict timeframes.

Ideal candidates will have a high school diploma or GED with 2 years of related experience, strong communication skills, and the ability to train for program

Qualifications

• Graduation from high school or GED and two (2) years of experience as an Eligibility Specialist or closely related experience.
• A higher education level may be considered as a substitution for all or part of the experience requirement.
• Excellent verbal and written communication skills are required for these positions.
• The candidates selected for these positions will need to be able to attend state and local trainings in regards to program requirements.
• The ideal candidate will demonstrate strong organizational skills, flexibility, professionalism, accountability, and a commitment to the WeCare principles of Integrity, Awareness, Accountability, Respect, and Excellence.

Responsibilities

• Work includes conducting applicant interviews, gathering and verifying required documentation, determining eligibility in accordance with federal and state Medicaid policies.
• Processing applications within established timeframes, and responding to inquiries from applicants, hospital personnel, and community partners.
• The employee will work independently in a hospital setting while maintaining effective communication and coordination with the Department of Social Services to ensure timely and accurate eligibility determinations.
• This position calls for the ability to work in a fast-paced, continuously evolving environment.
• The ability to communicate with customers from diverse backgrounds

Skills

Interpersonal skills

Time management

Organization

Independent work

Adaptability

Customer service

Education

High school diploma or GED

Job description

The Department of Social Services is seeking highly motivated, dependable professionals with advanced communication skills and exceptional customer service abilities to serve in an outstationed position at one of our partnering hospitals. This position is responsible for providing on-site assistance to individuals and families seeking Medicaid benefits, including accepting, reviewing, and processing Family and Children’s Medicaid (FCMA) and Adult Medicaid applications.

The successful candidate must be able to interpret complex Medicaid rules and regulations, exercise sound judgment in making appropriate eligibility decisions, and demonstrate exceptional organizational and time-management skills. The individual must also possess the ability to perform basic mathematical calculations, work efficiently within established deadlines, demonstrate proficiency with computer technology and general office equipment, and thrive in a collaborative, customer-focused environment. Strong interpersonal skills, adaptability, and the ability to work independently in a fast-paced hospital setting are essential for success in this position.
Graduation from high school or GED and two (2) years of experience as an Eligibility Specialist or closely related experience.

A higher education level may be considered as a substitution for all or part of the experience requirement.

Excellent verbal and written communication skills are required for these positions.

The candidates selected for these positions will need to be able to attend state and local trainings in regards to program requirements.

The ideal candidate will demonstrate strong organizational skills, flexibility, professionalism, accountability, and a commitment to the WeCare principles of Integrity, Awareness, Accountability, Respect, and Excellence.

• Work includes conducting applicant interviews, gathering and verifying required documentation, determining eligibility in accordance with federal and state Medicaid policies,

• processing applications within established timeframes, and responding to inquiries from applicants, hospital personnel, and community partners.

• The employee will work independently in a hospital setting while maintaining effective communication and coordination with the Department of Social Services to ensure timely and accurate eligibility determinations.

• This position calls for the ability to work in a fast-paced, continuously evolving environment.
• The ability to communicate with customers from diverse backgrounds