Medicaid Eligibility Specialist

Job Description

As part of the KanCare Clearinghouse Program, the Medicaid Eligibility Specialist will perform a variety of duties. The position is responsible for analyzing initial applications and supporting documentation to determine eligibility for federal and state medical assistance. This includes investigating applicant circumstances using available computer systems, documenting eligibility decisions in the electronic case journal, and communicating with customers and representatives.

• Analyze initial applications and supporting documentation to determine eligibility for medical assistance.
• Investigate applicant circumstances using available computer systems (Databases, registries, and informational deposits).
• Document eligibility decisions in the electronic case journal and send appropriate system-based and manual correspondence to customers and representatives.
• Make outbound calls to verify or obtain missing information when documentation is incomplete.
• Communicate with consumers regarding a variety of issues related to managed care enrollment.

Preferred Skills or Knowledge

• Knowledge of Medicaid and managed care programs.
• Minimum of two (2) years’ experience in determining Long-Term Care, Elderly and Disabled, or Family Medical eligibility.
• Successfully complete KDHE Eligibility Training and sandboxing.
• Manage competing priorities and demonstrate critical thinking skills.
• Use good interpersonal and communication skills, both verbally and in writing.
• Willingness to work as part of a team.

Minimum Qualifications/Experience

• High School diploma or GED equivalent; post-secondary education preferred.
• Strong computer skills with the ability to maneuver in complex software systems.
• Able to type 28-30 minutes per minute accurately.
• Experience with MS Office, Outlook, and Internet usage.

Bilingual Skills

The position requires the ability to speak and read both Spanish and English fluently.

Pay and Benefits

Actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated hourly rate for this role is $17.25.