Medicaid Eligibility & Renewal Expert

CenterLight Health System; New York (NY); On-site; USD 55,000 - 63,000; Full time

Job summary

CenterLight Health System seeks an Eligibility Support Specialist to assist PACE participants with Medicaid new and renewal applications, ensuring accuracy and timeliness. You will collaborate across Eligibility, Enrollment, IDT, Compliance, and Site Directors to support a smooth renewal process.

The role emphasizes QA, participant education, and continuous improvement of renewal workflows within our healthcare network in New York.

Qualifications

• Associate degree or equivalent business experience of 2 years as a minimum.
• Minimum of two (2+) years in the healthcare industry.
• Minimum of one (1+) year of experience working with the older adults.
• In-depth knowledge of government programs: Medicare, Medicaid, PACE.
• Excellent organizational and communication skills.
• Proficient with Microsoft Office software (Word, Excel, PowerPoint, and Outlook).

Responsibilities

• Assist participants in completing new and renewal Medicaid applications, ensuring accuracy and compliance.
• Submit new and renewal Medicaid applications within established timelines.
• Track application status and follow up with participants and departments to resolve issues.
• Conduct detailed reviews to confirm readiness and compliance with program standards.
• Identify and correct errors, omissions, or inconsistencies prior to submission.
• Maintain compliance with federal, state, and organizational regulations.
• Document quality assurance findings and recommend process improvements.
• Provide education to participants regarding timelines and required documentation.
• Collaborate in developing and distributing educational materials for Medicaid renewal.
• Conduct outreach to ensure timely submission and reduce lapses in coverage.

Skills

Customer Service

Analytical Skills

Collaboration

Organizational Skills

Adaptability

Problem Solving

Microsoft Office

Education

Associate degree

Tools

Microsoft Office

Job description

CenterLight Health System seeks an Eligibility Support Specialist to assist PACE participants with Medicaid new and renewal applications, ensuring accuracy and timeliness. You will collaborate across Eligibility, Enrollment, IDT, Compliance, and Site Directors to support a smooth renewal process.

The role emphasizes QA, participant education, and continuous improvement of renewal workflows within our healthcare network in New York.