Medicaid Enrollment Specialist

American Exchange; Tampa (FL); Presencial; USD 42 000 - 65 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

On-site role at partner clinics

Competitive salary

Benefits after 90 days

Training and ongoing support

Growth opportunities

Resumo da oferta

American Exchange in Tampa, FL seeks a Medicaid/ACA Enrollment Specialist to assist patients with eligibility screening, applications, and enrollment. The role involves on-site interaction with clinics, state agencies, and enrollment teams to ensure timely coverage and renewals.

The ideal candidate has experience with Medicaid/ACA enrollment, healthcare eligibility, and patient financial services, with a passion for helping underserved populations access care.

Qualificações

• 2+ years of experience in Medicaid/ACA enrollment or related healthcare administration.
• Experience completing Medicaid/ACA applications and navigating state eligibility systems preferred.
• Ability to explain complex eligibility requirements clearly and compassionately.
• Experience working with hospitals, clinics or health centers preferred.

Responsabilidades

• Screen Medicaid and ACA eligibility and assist with applications.
• Review income, household size, residency and immigration status for eligibility.
• Gather verification documents and monitor application status.
• Assist with renewals, redetermination, and coverage changes.
• Coordinate with providers and enrollment teams to minimize delays.

Conhecimentos

Strong communication

Organizational skills

Customer service

Problem solving

Formação académica

High school diploma or GED

Associate or Bachelor's degree in healthcare administration or related field

Ferramentas

Electronic health records

Enrollment portals

CRM systems

Microsoft Office & Google Workspace

Descrição da oferta de emprego

American Exchange is a growing health insurance enrollment and benefits organization that supports individuals, healthcare providers, employers, public programs, and community partners with health insurance enrollment, eligibility assistance, and ongoing support.

As we continue expanding our Medicaid/ACA enrollment services and healthcare partnerships, we are seeking a dedicated Medicaid/ACA Enrollment Specialist to assist patients with Medicaid/ACA eligibility screening, application submission, enrollment, renewals, and ongoing coverage support.

Position Overview

The Medicaid/ACA Enrollment Specialist will support American Exchange's Medicaid enrollment operations and completing ACA plans by assisting patients with determining eligibility, completing Medicaid applications, and ACA plans gathering required documentation, and navigating state Medicaid enrollment processes.

This role is an onsite work in Tampa Florida work closely with healthcare providers, clinic staff, patients, state Medicaid agencies, Insurance companies and American Exchange's internal enrollment teams to help uninsured and underinsured individuals obtain healthcare coverage.

This position is ideal for someone with experience in Medicaid enrollment, ACA plan analysis, healthcare eligibility, patient financial services, or hospital registration who is passionate about helping patients access healthcare.

Key Responsibilities

Medicaid Eligibility Screening and Enrollment

• Conduct Medicaid eligibility screenings for uninsured and underinsured patients.
• Conduct ACA eligibility screenings for uninsured and underinsured patients.
• Assist patients with completing and submitting Medicaid/ACA applications through applicable state enrollment systems.
• Review household income, family size, residency, citizenship or eligible immigration status, and other eligibility requirements.
• Identify potential eligibility for Insurance and other available healthcare coverage programs.
• Assist patients with gathering required verification documents, including proof of income, identification, residency, and household information.
• Monitor pending applications and follow up with state Medicaid/ACA agencies regarding application status.
• Assist patients with insurance renewals, redetermination, and coverage changes.
• Identify patients who may qualify for ACA Marketplace coverage when Medicaid eligibility requirements are not met, and coordinate appropriate referrals.

Patient Assistance and Education

• Serve as a primary point of contact for patients seeking Medicaid/ACA enrollment assistance.
• Explain Medicaid/ACA eligibility requirements, application procedures, coverage options, and next steps in clear, understandable language.
• Assist patients in navigating enrollment challenges, missing documentation, application denials, and coverage interruptions.
• Provide compassionate, professional assistance to patients from diverse socioeconomic backgrounds.
• Educate patients on maintaining coverage, reporting changes, and completing annual renewals.
• Coordinate with patients and healthcare providers to minimize delays in accessing medically necessary care.

Healthcare Provider and Clinic Coordination

• Work directly with healthcare facilities, clinics, registration departments, and patient financial services teams to identify patients needing Medicaid/ACA assistance.
• Support on-site services based on assigned healthcare partnerships.
• Communicate application status and outstanding documentation requirements to authorized clinic representatives.
• Coordinate with clinic staff to support patient follow-up and timely enrollment.
• Help establish efficient referral processes between healthcare providers and American Exchange enrollment teams.
• Escalate complex eligibility issues or enrollment barriers to management when necessary.

Documentation and Reporting

• Maintain accurate patient enrollment records, application statuses, and follow-up activities.
• Document all patient interactions and application progress in designated systems.
• Track completed applications, pending applications, approvals, denials, and outstanding documentation.
• Prepare daily, weekly, or monthly enrollment activity reports as requested.
• Monitor enrollment productivity and identify opportunities to improve application completion rates.
• Ensure patient information is handled securely and in accordance with HIPAA and applicable privacy requirements.

Compliance and Quality Assurance

• Follow federal and state Medicaid/ACA eligibility and enrollment guidelines.
• Participate in ongoing training, quality reviews, and process improvement initiatives.

Qualifications

• 2+ years of experience in Medicaid/ACA enrollment, healthcare eligibility, patient financial services, hospital registration, or related healthcare administration preferred.
• Experience completing Medicaid/ACA applications and navigating state eligibility systems strongly preferred.
• Understanding of Medicaid, ACA Marketplace coverage, and healthcare eligibility requirements.
• Familiarity with Medicaid/ACA renewals, eligibility verification, and application follow-up procedures.
• Experience working with hospitals, community health centers, federally qualified health centers (FQHCs), or physician practices preferred.
• Strong communication, organization, customer service, and problem-solving skills.
• Ability to explain complex eligibility requirements to patients in a clear and compassionate manner.
• Excellent attention to detail and ability to manage multiple applications simultaneously.
• Comfortable using electronic health records, enrollment portals, CRM systems, Microsoft Office, and Google Workspace.
• Ability to work independently while collaborating with healthcare providers and internal enrollment teams.
• High school diploma or GED required; associate or bachelor's degree in healthcare administration, social services, or a related field preferred.

Ideal Candidate

The ideal candidate is a compassionate, detail-oriented healthcare enrollment professional who understands Medicaid/ACA eligibility requirements and the importance of helping patients secure healthcare coverage.

This individual should be comfortable working directly with patients, healthcare providers, and state Medicaid agencies while managing multiple applications and maintaining accurate documentation.

The successful candidate will be proactive in following up on pending applications, resolving enrollment barriers, and helping American Exchange develop efficient, scalable Medicaid/ACA enrollment operations.

Compensation and Work Environment

• Full-time position.
• On-site at an assigned healthcare partner location, depending on operational needs.
• Competitive salary based on experience and qualifications.
• Benefits available after 90 days of employment.
• Training and ongoing support provided.
• Opportunity to grow within American Exchange's expanding Medicaid/ACA enrollment and healthcare services division.

Equal Opportunity Statement

American Exchange is an equal opportunity employer. We are committed to creating a professional, respectful, and inclusive work environment and encourage qualified candidates from all backgrounds to apply.