Medicaid Eligibility Specialist II: Frontline Impact

State of South Carolina; Columbia (SC); On-site; USD 42,000 - 56,000; Full time

Benefits offered by this job

Health, Dental, Vision Insurance

15 days annual leave

State Retirement Plan

Job summary

South Carolina Department of Health and Human Services seeks an Eligibility Specialist II (LTCW) to be the front-line contact for Medicaid eligibility. The role collects and evaluates documentation to determine eligibility, performs determinations and changes, and serves as a subject matter expert for the team.

The position requires in-office presence, adherence to privacy standards, and close collaboration with supervisors and beneficiaries.

Qualifications

• High school diploma and experience in customer services, social services, human services, and/or Medicaid processing.
• Bachelor's degree may be substituted for the required program experience.
• Familiarity with computers and standard Microsoft Office software; ability to read, write, and speak English clearly.
• Must be able to perform basic mathematical computations.

Responsibilities

• Collect, assemble, evaluate, and act upon information provided by applicants/beneficiaries and third parties to determine eligibility.
• Conduct timely determinations, reviews, and changes of circumstance according to policies.
• Document all notes and steps clearly in the systems of record.
• Escalate and resolve discrepancies using defined processes.
• Maintain professional communication with coworkers and beneficiaries and ensure privacy.

Skills

Customer service

Communication

Microsoft Office

English proficiency

Education

High school diploma

Bachelor's degree substitution allowed

Tools

Internet browsers

Job description

South Carolina Department of Health and Human Services seeks an Eligibility Specialist II (LTCW) to be the front-line contact for Medicaid eligibility. The role collects and evaluates documentation to determine eligibility, performs determinations and changes, and serves as a subject matter expert for the team.

The position requires in-office presence, adherence to privacy standards, and close collaboration with supervisors and beneficiaries.