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Eligibility Trainee/ Professional

2 months ago


Shawnee, United States State of Kansas Full time

Employment Benefits

Comprehensive medical, mental, dental, vision, and additional coverage Sick & Vacation leave Work-Life Balance programs: parental leave, military leave, jury leave, funeral leave Paid State Holidays (designated by the Governor annually) Fitness Centers in select locations Employee discounts with the Retirement and deferred compensation programs

Position Summary & Responsibilities

Position Summary:

The Eligibility Trainee/ Professional (K0230152) Complete the eligibility determination for KanCare (Medicaid and CHIP) and other family medical programs in a timely, accurate and customer responsive manner. This determination is a situation utilizing screening information compiled by the KanCare Eligibility contractor. Investigation of the customer’s circumstances through the use of available computer information systems, researching records provided by the customer and direct customer contact provide the information upon which the eligibility determination is based. Operation of a computer is essential to document eligibility decisions.

Job Responsibilities may include but are not limited to the following:

Develop a positive working relationship with KanCare Eligibility contract staff in order to assist customers in accessing appropriate services. Represents the agency to the contractor and uses a non-judgmental attitude, communication skills and a working understanding of human behavior to establish an atmosphere in which mutual goals are achieved and positive working relationships are maintained. Act as a resource to the KanCare Eligibility contractor. This may include one-on-one assistance with the screening of medical applications and reviews in addition to medical eligibility determinations.

Analyzes the implications of policy and procedural decisions and provides input regarding the impact on customers, staff and the operation of medical programs. Uses knowledge of state eligibility processes and policies and procedures governing managed care enrollment to coordinate and advise on work processes, interpret guidelines or instructions, elicit opinions, resolve conflicts or give guidance to agency and contract staff.

Qualifications

Education : High School, GED or six months experience determining Long-Term Care, Elderly and Disabled, or Family Medical eligibility. Education may be substituted for experience as determined relevant by the agency. Licensing & Certification: Valid Driver's License - Incumbent is required to have and maintain a valid driver's license when operating a state vehicle, a private vehicle, or a rental vehicle for the benefit of the State. Preferred Qualifications: Bachelor’s Degree or some post-secondary education Word, Excel, PowerPoint, Access Proofreading, editing, attention to detail Independent judgment and initiative Effective communication both verbally and written Experience working in a paperless system or using imaging Experience providing excellent customer service Experience interviewing, investigating, compiling information, and documenting decisions Experience making eligibility determinations using regulations, policies, and procedures Medicaid experience using regulations, policies and procedures Knowledge of Medicaid program Experience utilizing computer, imaging & eligibility determination system Demonstrated analytical skills Ability to manage competing priorities