Medicaid Eligibility Quality & Compliance Analyst

Acro Service Corp; New Castle (DE); On-site; USD 60,000 - 85,000; Full time

Job summary

Acro Service Corp is seeking a MEQC reviewer to conduct in-depth case reviews, validate eligibility determinations, and assess supporting documentation to inform system improvements.

You will review Medicaid and CHIP active and negative files for accuracy and compliance, compare decisions with MAGI and non-MAGI pathways, identify discrepancies and root causes, track findings in Excel and internal systems, and prepare policy-cited summaries for audits and federal reporting.

Responsibilities

• Review and analyze Medicaid and CHIP active and negative case files for accuracy and compliance.
• Compare eligibility decisions with applicable state and federal policy requirements, including MAGI and non-MAGI pathways.
• Identify and document discrepancies, error trends, and root causes.
• Track and report findings using Excel, Adobe and internal systems like ASSIST Worker Web and DMES.
• Prepare clear, policy-cited written summaries of case reviews suitable for audit and federal reporting.
• Collaborate with team members to identify root causes of errors and support corrective actions.

Job description

Acro Service Corp is seeking a MEQC reviewer to conduct in-depth case reviews, validate eligibility determinations, and assess supporting documentation to inform system improvements.

You will review Medicaid and CHIP active and negative files for accuracy and compliance, compare decisions with MAGI and non-MAGI pathways, identify discrepancies and root causes, track findings in Excel and internal systems, and prepare policy-cited summaries for audits and federal reporting.