Medicaid Eligibility Specialist

Job Summary

Supporting the mission of providing timely and accurate eligibility and enrollment information, the full-time Medicaid Eligibility Specialist will work in a hybrid capacity, spending three days remote, while managing Medicaid applications and ensuring compliance with CMS and EOHHS regulations.

Key responsibilities

• Maintains accurate enrollment and billing records, ensuring compliance with internal and external deadlines
• Collaborates with various departments to resolve discrepancies and improve processes related to eligibility and premium billing
• Handles confidential customer information and ensures data integrity within core systems

Required qualifications

• High school diploma required; bachelor's degree preferred
• Over 4 years of experience in an office environment, preferably in healthcare or managed care
• Strong analytical skills and aptitude for mathematical fundamentals
• Proficiency in MS Excel, MS Word, and MS Access
• Knowledge of Medicare and Medicaid eligibility requirements is highly desirable