California Licensed Eligibility Specialist

Job Summary

A company is looking for an Eligibility Specialist to address complex eligibility challenges and ensure participant coverage.

Key Responsibilities

• Act as an organizational expert in Medicare and Medicaid eligibility policies and provide guidance on compliance requirements
• Oversee the resolution of complex eligibility issues and advocate for participants in disputed cases
• Develop and deliver training programs for internal teams to improve eligibility accuracy and efficiency

Required Qualifications

• Associate's degree in a relevant field; relevant experience may be substituted
• Minimum of three (3) years of experience in Medicaid, Medicare, or social services
• Minimum of one (1) year of experience working with governmental agencies
• Experience leading in a data-driven organization, leveraging reports and data for project management