Medicaid Eligibility Specialist

CareWell Services; Battle Creek (MI); On-site; USD 35,000 - 50,000; Full time

Job summary

A community health organization in Battle Creek, Michigan, seeks a Medicaid Eligibility Specialist to coordinate and assist participants in the Medicaid program. The ideal candidate will complete applications, manage eligibility determinations, and work with various stakeholders to ensure compliance. Candidates must have a high school diploma, with an associate degree preferred, and experience in social services with Medicaid knowledge. This role offers an opportunity to make a significant impact in the community while maintaining a professional demeanor.

Qualifications

• Minimum of one year of related experience in a social service or healthcare setting.
• Minimum of four years of experience with Medicaid and Medicaid eligibility requirements.

Responsibilities

• Completing and filing Medicaid applications and related documents.
• Conducting redeterminations for continued eligibility in the MI Choice Waiver program.
• Coordinating with various entities to obtain necessary information.
• Assisting in quality monitoring of eligibility and records.
• Maintaining detailed record keeping and chart documentation.

Skills

Professional personality and demeanor

Flexible and adaptable

Basic office skills

Detail-oriented

Proficient in Microsoft Office Suite

Excellent organizational skills

Excellent written and verbal communication skills

Ability to maintain confidential information

Education

High school diploma or GED

Associate degree in social services or administrative services (preferred)

Tools

Microsoft Office Suite

Job description

This position is not a remote position!!

Position Summary

The Medicaid Eligibility Specialist is responsible for coordinating with various agency programs to advocate and assist participants for applying and requalifying for the Medicaid program.

Essential Job Functions

• Responsible for completing and filing Medicaid application, DHS1004, Asset Declaration, Waiver Conversion/Transfer, Waiver Checklist, FAP, and SER for MI Choice Waiver program according to agency standards and requirements of Michigan Department of Health and Human Services (MDHHS).
• Conducts redeterminations for participants’ continued eligibility in the MI Choice Waiver program according to required timelines.
• Coordinates with financial entities, Supports Coordinators, co-workers, participants, and participants’ families to obtain necessary information and documentation requested by MDHHS.
• Assists in department monitoring program as it relates to quality and auditing of participant eligibility and records.
• Conducts detailed record keeping and chart documentation.
• Supports achievement of Agency’s mission, vision, and reflects its values in work behavior.
• Performs all other duties as assigned.

EDUCATION:

High school diploma or GED required. Associate degree in social services, administrative services preferred.

EXPERIENCE:

Minimum of one year of related experience in a social services, healthcare or non-profit setting is required. Minimum of four years of experience with Medicaid and Medicaid eligibility requirements.

REQUIRED SKILLS:

• Professional personality and demeanor to work with the public and assist participants.
• Flexible and adaptable in various situations and when interacting with many different personalities.
• Basic office skills such as typing and filing.
• Detail-oriented and professional.
• Proficient in Microsoft Office Suite and related software.
• Ability to analyze and diagnose problems and work independently to solve them.
• Excellent organizational skills and attention to detail.
• Ability to operate general office equipment.
• Excellent written and verbal communication skills.
• Ability to maintain confidential information.

PREFERRED SKILLS: MS Office including Excel, Word, etc. and Software programs specific to the agency for data gathering, and other office machines. Bi-lingual.

PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Specific vision abilities required by this job include close vision, distance vision, and the ability to adjust focus. The employee is frequently required to sit at a computer for long periods of time. The employee may be required to lift and/or move up to 15 pounds. The employee must travel in all kinds of weather and have reliable transportation.

Equal Opportunity Employer, including disabled and veterans.