In-Person Medicaid Eligibility Specialist – Help Families

State-of-Washingto; Olympia (WA); On-site; USD 70,000 - 90,000; Full time

Job summary

Washington State Health Care Authority in Olympia, WA seeks a Medical Assistance Specialist 3 to determine eligibility for Apple Health (Medicaid) and related programs. In-person, face-to-face service in a lobby setting will be required, with interaction by phone and written correspondence as needed.

You will apply federal and state rules (WAC/RCW) to diverse household circumstances, research complex cases, and use systems like ACES, Washington Healthplanfinder, ProviderOne, and the DMS to

Qualifications

• Interpret and apply regulations, policies, and procedures accurately.
• Research, analyze, and evaluate complex information to determine eligibility.

Responsibilities

• Independently determine initial and ongoing eligibility for Medicaid Title XIX, CHIP Title XXI, and other programs.
• Apply complex federal and state rules (WAC/RCW) to households to authorize benefits.
• Research and resolve complex eligibility issues with minimal supervision.
• Operate multiple systems: ACES, Washington Healthplanfinder, ProviderOne, DMS.
• Interview clients, providers, and third parties to gather verification for eligibility.
• Provide direct, face-to-face customer support in lobby offices.
• Collaborate with advocates, providers, the Health Benefit Exchange, and other agencies.
• Support Take Charge family planning eligibility questions and participate in process improvements.

Skills

Regulations interpretation

Independent analysis

Complex problem resolution

Technical research

Customer consultation

Professional communication

Quality and compliance

Workload management

Education

Bachelor's degree in related field

Tools

ACES

Washington Healthplanfinder

ProviderOne

Document Management System (DMS)

Job description

Washington State Health Care Authority in Olympia, WA seeks a Medical Assistance Specialist 3 to determine eligibility for Apple Health (Medicaid) and related programs. In-person, face-to-face service in a lobby setting will be required, with interaction by phone and written correspondence as needed.

You will apply federal and state rules (WAC/RCW) to diverse household circumstances, research complex cases, and use systems like ACES, Washington Healthplanfinder, ProviderOne, and the DMS to