Medicaid Eligibility & Financial Determination Specialist

InnovAge Holding Corp.; Denver (CO); On-site; USD 51,000 - 64,000; Full time

Benefits offered by this job

Medical Insurance

401(k) Plan

Paid Holidays

Job summary

InnovAge is seeking an Eligibility & Financial Determination Specialist to oversee Medicaid applications for InnovAge PACE Participants in partnership with Enrollment Representatives.

Responsibilities include reviewing applications, coordinating documentation, ensuring compliance with Medicaid rules, and tracking status from submission to approval. The role supports a smooth transition to Medicaid eligibility and works with Medicaid Controller and staff.

Qualifications

• 3+ years total related experience.
• 1+ year with CBMS Medicaid systems and knowledge of Medicaid system and benefits.
• High School diploma or GED.
• Requires a valid state issued driver's license, personal transportation, good driving record and auto insurance as required by law.

Responsibilities

• Reviews applications from the Enrollment Representative Group and works closely with them in obtaining necessary documentation needed for Medicaid approval.
• Tracks applications from first submission to approvals and serves as the primary contact for enrollment representatives.
• Ensures compliance with all State Medicaid Rules and Regulations with applications being submitted by Innovage to the County Agencies.

Skills

Medicaid knowledge

Documentation skills

Education

High School Diploma

Bachelor's Degree

Tools

CBMS Medicaid

Job description

InnovAge is seeking an Eligibility & Financial Determination Specialist to oversee Medicaid applications for InnovAge PACE Participants in partnership with Enrollment Representatives.

Responsibilities include reviewing applications, coordinating documentation, ensuring compliance with Medicaid rules, and tracking status from submission to approval. The role supports a smooth transition to Medicaid eligibility and works with Medicaid Controller and staff.