Remote Medicaid Provider Eligibility Specialist

Minnesota Department of Human Services; Saint Paul (MN); Hybrid; USD 33,000 - 48,000; Full time

Benefits offered by this job

Health insurance

Paid leave

12 paid holidays

Pension plan

EAP

Job summary

Minnesota Department of Human Services is seeking a Provider Eligibility and Compliance Specialist in St. Paul, MN.

The role focuses on screening, enrolling, and maintaining provider records to ensure compliance with State and Federal requirements for MHCP providers. Responsibilities include evaluating eligibility, processing initial enrollments, and maintaining ongoing MHCP eligibility through screening, certification, and licensure updates.

Qualifications

• Resume must clearly describe experience with month/year for each job
• 2 years advanced administrative support or paraprofessional experience
• Associate degree with 1 year related experience or Bachelor’s degree
• Experience with Medicaid provider enrollment and eligibility criteria
• Experience with MPSE, MMIS or similar claims systems

Responsibilities

• Screen, enroll, and maintain provider records to meet state and federal requirements
• Analyze provider enrollment and eligibility for counties, providers, and groups
• Respond to inquiries and draft analyses related to PEC policies and activities
• Modify systems, policies, and procedures based on investigations and findings

Skills

Lay language translation

Customer service

Problem solving

MS Office

Diversity collaboration

Education

Associate degree

Bachelor’s degree

Tools

MMIS / MPSE

Job description

Minnesota Department of Human Services is seeking a Provider Eligibility and Compliance Specialist in St. Paul, MN.

The role focuses on screening, enrolling, and maintaining provider records to ensure compliance with State and Federal requirements for MHCP providers. Responsibilities include evaluating eligibility, processing initial enrollments, and maintaining ongoing MHCP eligibility through screening, certification, and licensure updates.