Remote Medi-Cal Eligibility Strategist

Libertana; Los Angeles (CA); Hybrid; USD 77,366,000 - 85,962,000; Full time

Job summary

Paycom - ATS is seeking a Medi-Cal Eligibility Resolution Specialist to identify, resolve, and prevent Medi-Cal eligibility issues, ensuring timely redeterminations and coordination with county offices.

The role is primarily remote with required field visits to county Medi-Cal offices; specialists work with internal teams to support members through complex eligibility processes and maintain compliant documentation.

Qualifications

• Strong knowledge of Medi-Cal eligibility rules and redetermination processes.
• Experience with electronic health record systems and state eligibility systems.
• Proficient in Microsoft Word and Excel.
• Bilingual in Spanish preferred.
• Bachelor’s degree in healthcare, business administration or related field.

Responsibilities

• Investigate and resolve Medi-Cal eligibility barriers for members.
• Conduct eligibility verification using state systems and EMR platforms.
• Communicate with county eligibility workers to clarify status and actions.
• Coordinate redetermination submissions and track cycles.
• Perform in-person county visits as needed.

Skills

Medi-Cal knowledge

Communication skills

Spanish bilingual

Education

Bachelor's degree in healthcare or related field

Tools

EMR platforms

Microsoft Word

Microsoft Excel

Job description

Paycom - ATS is seeking a Medi-Cal Eligibility Resolution Specialist to identify, resolve, and prevent Medi-Cal eligibility issues, ensuring timely redeterminations and coordination with county offices.

The role is primarily remote with required field visits to county Medi-Cal offices; specialists work with internal teams to support members through complex eligibility processes and maintain compliant documentation.