Remote Medicaid Eligibility & Enrollment Specialist

Blue Cross & Blue Shield of Rhode Island; United States; Hybrid; USD 38,000 - 52,000; Full time

Benefits offered by this job

Remote and hybrid options

Paid time off

Tuition reimbursement

Student-loan repayment assistance

Health insurance

Mental health programs

Bonuses

Investment plans

Volunteer time off

Job summary

Blue Cross & Blue Shield of Rhode Island is seeking a Medicaid Eligibility Specialist in Providence to assess prospective members, explain Medicaid rules, and serve as a liaison with EOHHS. Hybrid and remote options are available based on role.

You will support annual redeterminations, verify documentation, log progress in SFDC, and participate in ongoing training to ensure timely processing. A high school diploma and up to two years of related experience are required.

Qualifications

• High school diploma or GED required.
• Up to two years of related professional experience.
• Excellent interpersonal and communication skills.
• Working knowledge of Medicaid rules and computer software.
• Ability to communicate to various levels of personnel.
• Proficient computer navigation and data organization.
• Ability to work independently and meet deadlines.
• Sound judgment and time management.
• Written and verbal communications skills.
• Ability to collect and organize data.

Responsibilities

• Conduct eligibility assessment of prospective Medicaid members.
• Explain Medicaid rules and regulations to members.
• Serve as liaison between prospective members and EOHHS.
• Assist with redetermination by verifying eligibility and required documents.
• Follow up with members and EOHHS caseworkers to ensure timely processing.
• Maintain log of Medicaid eligibility and complete re-determinations.
• Document progress notes in SFDC.
• Participate in ongoing training.
• Occasionally perform home visits to complete applications.
• Perform other duties as assigned.

Skills

Interpersonal skills

Negotiation

Communication

Time management

Data organization

Independent work

Judgment

Written & verbal communications

Documentation skills

Education

High school diploma or GED

Tools

SFDC

Microsoft Office

Job description

Blue Cross & Blue Shield of Rhode Island is seeking a Medicaid Eligibility Specialist in Providence to assess prospective members, explain Medicaid rules, and serve as a liaison with EOHHS. Hybrid and remote options are available based on role.

You will support annual redeterminations, verify documentation, log progress in SFDC, and participate in ongoing training to ensure timely processing. A high school diploma and up to two years of related experience are required.