Medicaid Eligibility & Enrollment Specialist

Senior TLC; Charlotte (NC); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

None

Job summary

Senior TLC in Charlotte, NC seeks a Medicaid Specialist to support Medicaid applications and annual recertifications. The role collaborates with Case Managers, Medicaid specialists/paralegals, care teams, participants, and family caregivers to streamline processes and reduce delays.

Qualifications include a high school diploma, 1+ year in Medicaid work with frail elderly populations, and NC driver’s license with reliable vehicle. Immunizations must be up to date.

Qualifications

• Education: High school diploma or equivalent.
• Experience: At least 1 year with frail elderly populations and Medicaid applications.
• Licensure: Valid North Carolina Driver’s License & reliable vehicle.
• Immunizations: Up-to-date vaccines and medical clearance before direct contact.

Responsibilities

• Assist with processing Medicaid applications and annual recertifications; upload documents to CRM and notify DSS.
• Perform administrative tasks and maintain accurate Medicaid records and correspondence.
• Update enrollment status in CRM to ensure accurate reporting to DSS and care teams.
• Interpret Medicaid policy for each PACE application and recertification.
• Coordinate with Case Managers to ensure enrollment and eligibility processes and timely notifications.
• Support Enrollment Administrative Assistant with Medicaid inquiries and guidance.
• Maintain onsite presence to facilitate communication with staff and home visits when needed.
• Lead training meetings with staff on current policies related to PACE Medicaid.
• Communicate enrollment changes to care teams and ensure CRM accuracy and referrals closed.
• Manage relationships with DSS, caseworkers, law firms, and contracted employees for PACE apps.
• Oversee annual documentation updates and reports, including address changes and disenrollments.
• Conduct monthly audits of the Pre-Paid Enrollment Report for Patient Monthly Liabilities.

Skills

Communication

Interpersonal skills

Conflict resolution

Team collaboration

Education

High school diploma or equivalent

Tools

CRM system

Job description

Senior TLC in Charlotte, NC seeks a Medicaid Specialist to support Medicaid applications and annual recertifications. The role collaborates with Case Managers, Medicaid specialists/paralegals, care teams, participants, and family caregivers to streamline processes and reduce delays.

Qualifications include a high school diploma, 1+ year in Medicaid work with frail elderly populations, and NC driver’s license with reliable vehicle. Immunizations must be up to date.