Senior Care Medicaid Eligibility Specialist

One Senior Care; Pennsylvania; On-site; USD 42,000 - 66,000; Full time

Benefits offered by this job

Paid holidays

PTO 3 weeks + 1 day/year

Life and AD&D insurance

Health Savings Account

Flexible Spending Account

Short Term Disability

Voluntary Life Insurance (Employee/Sp/

Tuition Reimbursement

Retirement plan with company match

Mileage reimbursement

Job summary

One Senior Care in Pennsylvania seeks a Medicaid Eligibility Specialist to manage Medicaid applications from intake through enrollment, renewals, and ongoing eligibility for PACE participants. You will ensure accuracy, follow established procedures, and provide reliable support to internal teams and external partners.

The role emphasizes detail-oriented work, independence, and timely communication with county offices to keep participants safely connected to services.

Qualifications

• Must demonstrate high accuracy and attention to detail.
• Experience following clearly defined processes and procedures.
• Patient, conscientious and able to double-check work for quality.

Responsibilities

• Manage transition of Medicaid applications from intake to establish eligibility for new participants.
• Monitor eligibility for pending and presumptive enrollees and respond to information requests.
• Track and manage Medicaid renewals and redeterminations using workflows and timelines.
• Support the appeals process on behalf of participants when needed.
• Coordinate with county offices and internal teams to ensure documents are received and submitted accurately.
• Respond to changes in participant Medicaid status in a timely manner.
• Conduct ongoing monitoring of eligibility including annual and situational redeterminations.
• Communicate eligibility status, renewal deadlines, and documentation needs to internal teams.
• Build and maintain professional relationships with county offices for timely issue resolution.

Skills

Attention to detail

Accuracy

Process adherence

Organized

Independent work

Communication

Education

High school diploma or equivalent

Job description

One Senior Care in Pennsylvania seeks a Medicaid Eligibility Specialist to manage Medicaid applications from intake through enrollment, renewals, and ongoing eligibility for PACE participants. You will ensure accuracy, follow established procedures, and provide reliable support to internal teams and external partners.

The role emphasizes detail-oriented work, independence, and timely communication with county offices to keep participants safely connected to services.