Medicaid Eligibility Specialist — Hybrid Role

State-of-Washingto; Federal Way (WA); Hybrid; USD 60,000 - 85,000; Full time

Benefits offered by this job

Hybrid schedule

Remote work options

Paid holidays

Professional development

Job summary

The Washington State Health Care Authority (HCA) is seeking a Medical Assistance Specialist 3 for Federal Way Public Health to determine eligibility for Apple Health (Medicaid), CHIP, and other state programs. This is a full-time, hybrid role with onsite client interactions in Federal Way, WA.

You will apply state/federal rules, conduct onsite interviews, and use multiple systems to gather documentation and verify eligibility for residents of Washington.

Qualifications

• Experience interpreting regulations, policies, and procedures.
• Ability to independently research, analyze, and determine outcomes.
• Strong problem resolution and complex issue handling.
• Research and interpret complex program rules and policies.
• Provide accurate information to customers and partners.
• Clear and professional written and verbal communication.
• Commitment to accuracy, compliance, and quality of work.
• Organize and prioritize complex assignments with minimal supervision.

Responsibilities

• Independently determine initial and ongoing eligibility for Medicaid and CHIP.
• Apply federal and state eligibility rules to households' circumstances.
• Research and resolve complex eligibility issues with independence.
• Use systems like ACES, Washington Healthplanfinder, ProviderOne, DMS.
• Conduct onsite client interviews and communicate with clients and providers.
• Update eligibility records and assist access to medical care.
• Coordinate with advocates, providers, and state agencies on referrals.
• Participate in process-improvement efforts for MEDS operations.

Skills

Regulatory interpretation

Independent analysis

Problem resolution

Technical research

Customer consultation

Professional communication

Quality & compliance

Workload management

Education

Bachelor's or Associate degree

Tools

Microsoft Office (Outlook, Word, SharePoint)

Job description

The Washington State Health Care Authority (HCA) is seeking a Medical Assistance Specialist 3 for Federal Way Public Health to determine eligibility for Apple Health (Medicaid), CHIP, and other state programs. This is a full-time, hybrid role with onsite client interactions in Federal Way, WA.

You will apply state/federal rules, conduct onsite interviews, and use multiple systems to gather documentation and verify eligibility for residents of Washington.