Medicaid Eligibility Specialist - Senior Care (PACE)

One Senior Care; United States; À distance; USD 42 000 - 64 000; Plein temps

Avantages offerts par ce poste

9 Paid Holidays

PTO 3 weeks + 1 day per year

Life and AD&D Insurance

Health Savings and Flexible Spending

Short Term Disability

Group Term Life Insurance for Employee

Tuition Reimbursement and PaidTraining

Retirement Plan with company match

Mileage Reimbursement

Résumé du poste

One Senior Care is hiring a Medicaid Eligibility Specialist to ensure eligibility is established and maintained for participants in the PACE program. You will manage transitions from intake to enrollment and renewals, coordinating with county offices to keep access to services uninterrupted.

This role suits detail-oriented, process-driven individuals who work well independently yet collaborate with internal teams. Prior Medicaid/PACE exposure is preferred and training is provided.

Qualifications

• High school diploma or equivalent required.
• Knowledge of Medicaid, Medicare, and PACE eligibility regulations preferred.
• At least one year of experience working with the frail or elderly population, or willingness to complete extensive training.
• Experience using electronic records or case management systems is a plus.

Responsabilités

• Manage Medicaid eligibility from intake to enrollment and renewals for participants.
• Monitor eligibility for pending and presumptive enrollees and respond to information requests from county offices.
• Track and manage Medicaid renewals and revalidations using established workflows and timelines.
• Support the appeals process on behalf of participants when needed.
• Coordinate with county offices and internal teams to ensure documentation is received and submitted accurately.
• Communicate changes in participant Medicaid status and policy updates to internal teams.

Connaissances

Detail-oriented

Process-driven

Organized

Independent work

Medicaid knowledge

Formation

High school diploma

Outils

Case management systems

Description du poste

One Senior Care is hiring a Medicaid Eligibility Specialist to ensure eligibility is established and maintained for participants in the PACE program. You will manage transitions from intake to enrollment and renewals, coordinating with county offices to keep access to services uninterrupted.

This role suits detail-oriented, process-driven individuals who work well independently yet collaborate with internal teams. Prior Medicaid/PACE exposure is preferred and training is provided.