Medicaid Eligibility & Enrollment Specialist

Senior Community Care of Kentucky; Louisville (KY); On-site; USD 47,000 - 54,000; Full time

Benefits offered by this job

403(b) with discretionary contribution

Paid Time Off + Personal Days

Life Insurance & Short-Term Disability

Employee Assistance Program

Wellness incentives

Get paid early

Job summary

Senior Community Care of Kentucky PACE in Louisville, KY seeks an Eligibility Specialist to initiate admissions, coordinate intake, and connect participants with community resources. You will promote the PACE program to participants and agencies, help with Medicaid applications, SNAP, and re-certifications, and support enrollment with CMS requirements.

This full-time role offers a competitive pay range of $47,000–$54,000, benefits, and opportunities for growth in a mission-driven healthcare

Qualifications

• Must have medical clearance for communicable diseases and up-to-date immunizations before having direct participant contact.
• Must have a valid driver’s license and have means of transportation.
• Must clear background check.

Responsibilities

• In collaboration with Enrollment Specialist, gather necessary documentation and application requirements in working with participants for Medicaid approval.
• Ensures compliance with all State Medicaid Rules and Regulations that pertain to Long Term Care Medicaid.
• Assists participants with applications to Supplemental Nutrition Assistance Program (SNAP), and other state specific Medicaid or public assistance programs for which participants may be eligible.
• Tracking private pay and Medicare-only clients and instrumental in obtaining a smooth transition to Medicaid eligibility. Ensures appropriate forms are completed and participant understanding of financial responsibility when not eligible for Medicare or Medicaid.
• Works with Health Plan Operations Team and Executive Director to ensure A/R Aging report is tracked and monitored, and outstanding debts are collected.
• Reviews and monitors eligibility report provided by Health Plan Operations Team to ensure participants who lose benefits are provided support with re-establishing eligibility.
• Guides participants through financial eligibility process. Supports participants with gathering and submitting supplemental documents which are required to establish eligibility for benefits.
• Provide education on program regulations and other pertinent material to applicants, recipients, and the general public.
• This role is a provider authorized representative for participants’ Medicaid benefits. Reviews Medicaid eligibility, monitors time frame for re-certification and facilitates Medicaid applications for certification and re-certification using state specific Medicaid process.
• Collects data and prepares reports in accordance with Centers for Medicare and Medicaid Services (CMS) requirements or program requirements.

Education

Bachelor's Degree in a health and human services field or equivalent four (4) years of experience related to public benefits

Job description

Senior Community Care of Kentucky PACE in Louisville, KY seeks an Eligibility Specialist to initiate admissions, coordinate intake, and connect participants with community resources. You will promote the PACE program to participants and agencies, help with Medicaid applications, SNAP, and re-certifications, and support enrollment with CMS requirements.

This full-time role offers a competitive pay range of $47,000–$54,000, benefits, and opportunities for growth in a mission-driven healthcare