Current jobs related to Medicaid Eligibility Specialist - San Diego CA United States - Mesa County Health Department
-
Bilingual Medicaid Eligibility Specialist
2 weeks ago
San Jose, California, United States Regional Medical Center of San Jose Full timeJob SummaryThe Regional Medical Center of San Jose is seeking a highly skilled Bilingual Medicaid Eligibility Advocate to join our team. As a key member of our patient financial services department, you will play a critical role in ensuring that our patients receive the financial support they need to access quality healthcare.Key ResponsibilitiesConduct...
-
Eligibility Supervisor
3 days ago
, WI, United States Humana Full timeLead the Way in Medicaid EligibilityAs an Eligibility Supervisor with Humana, you will play a critical role in ensuring the successful operation of our Financial Eligibility area. You will be responsible for managing and assigning tasks, collaborating with internal teams, and providing daily leadership and mentoring to staff. Your expertise in enrollment,...
-
Bilingual Medicaid Eligibility Specialist
3 days ago
San Jose, California, United States Regional Medical Center of San Jose Full timeJob SummaryWe are seeking a highly skilled Bilingual Medicaid Eligibility Advocate to join our team at Regional Medical Center of San Jose. As a key member of our patient financial services team, you will play a critical role in ensuring that our patients receive the financial support they need to access quality healthcare.Key ResponsibilitiesConduct...
-
Medicaid Market Access Specialist
14 hours ago
San Diego, California, United States Vets Hired Full timeAbout the JobVets Hired is seeking a highly skilled Medicaid Market Access Manager to join our team. As a key member of our organization, you will play a critical role in identifying Medicaid agency contacts and policy change processes for target states.Key ResponsibilitiesPartner with the GeneDx sales team to identify state-specific KOLs in support of...
-
Eligibility Specialist I
3 days ago
, FL, United States My Florida Corp Defunct Full timeAbout the RoleWe are seeking a highly skilled Eligibility Specialist to join our team at the Department of Children and Families. As an Eligibility Specialist, you will play a critical role in determining the eligibility of applicants and recipients for public assistance programs.Key ResponsibilitiesInterview applicants to obtain and verify information...
-
Eligibility Specialist I
5 days ago
, FL, United States My Florida Corp Defunct Full timeAbout the RoleWe are seeking a highly skilled Eligibility Specialist to join our team at the Department of Children and Families. As an Eligibility Specialist, you will play a critical role in determining the eligibility of applicants and recipients for public assistance programs.Key ResponsibilitiesInterview applicants to obtain and verify information...
-
Child Protective Services Eligibility Specialist
2 weeks ago
San Antonio, Texas, United States Texas Department of Aging & Disability Services Full timeJob Summary: We are seeking a highly skilled Foster Care Eligibility Specialist II to join our team at the Texas Department of Aging & Disability Services. As a Foster Care Eligibility Specialist II, you will play a critical role in determining and certifying eligibility for foster care, Medical Assistance Only, and Adoption Assistance in the Child...
-
Medicaid Advocate
5 days ago
Anaheim, CA, United States VirtualVocations Full timeA company is looking for a Medicaid Services Advocate in Remote, USA! Key Responsibilities: Respond to customer inquiries regarding benefits, eligibility, and claims Educate customers on consumer-driven health care topics and assist in navigating healthcare websites Research and resolve complex customer issues across multiple databases Required...
-
Medical Eligibility Coordinator
1 week ago
San Antonio, Texas, United States CommuniCare Health Center Full timeJob SummaryCommuniCare Health Center is seeking a highly skilled Medical Eligibility Specialist to join our team. As a Medical Eligibility Specialist, you will play a critical role in ensuring that patients receive the healthcare services they need by verifying their eligibility for various programs and services.Key ResponsibilitiesEligibility Verification:...
-
Medical Eligibility Specialist
3 weeks ago
San Antonio, United States CommuniCare Health Center Full timeResponsible to provide excellent customer service to all members of the Center. Ensures patient accounts are managed and assists patients with account summarization. Facilitates client qualification for and enrollment in a Qualified Health Plan (QHP) through the Federal Marketplace, Medicaid/CHIP and/or other health programs/grants. Assists qualified...
-
Medical Eligibility Coordinator
2 weeks ago
San Antonio, Texas, United States CommuniCare Health Center Full timeJob SummaryCommuniCare Health Center is seeking a highly skilled Medical Eligibility Specialist to join our team. As a Medical Eligibility Specialist, you will play a critical role in ensuring that patients receive the healthcare services they need by verifying their eligibility for various programs and services.Key ResponsibilitiesEligibility Verification:...
-
Eligibility Specialist I
6 days ago
, CA, United States County of Sonoma Full timeJob SummaryWe are seeking a highly skilled Eligibility Specialist I to join our team at the County of Sonoma Human Services Department. As an Eligibility Specialist I, you will play a critical role in determining eligibility for benefits, including Medi-Cal, CalFresh, and other health insurance programs. This is an exciting opportunity to make a difference...
-
Medical Eligibility Coordinator
13 hours ago
San Antonio, Texas, United States CommuniCare Health Center Full timeJob SummaryWe are seeking a highly skilled and detail-oriented Medical Eligibility Specialist to join our team at CommuniCare Health Center. As a Medical Eligibility Specialist, you will play a critical role in ensuring that our patients receive the best possible care by facilitating their access to health insurance programs and services.Key...
-
CPS FC Elig Spec II
1 month ago
San Antonio, United States Texas Department of Aging & Disability Services Full timeJob Description: CPS FC Elig Spec II CPS FC Elig Spec II - The Foster Care/Adoption Assistance Eligibility Specialist position is responsible for determining and certifying eligibility for foster care, Medical Assistance Only and Adoption Assistance in the Child Protective Services program. The position uses application forms and interprets policy to...
-
Medicaid Claims Analyst
1 week ago
Parsippany, NJ, United States Cognizant Full timeAbout Us: Cognizant (Nasdaq: CTSH) engineers’ modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life. See how at www.cognizant.com The role is encouraged to drive technology discussions and analyze the current...
-
Medicaid Claims Analyst
2 weeks ago
Parsippany, NJ, United States Cognizant Full timeAbout Us: Cognizant (Nasdaq: CTSH) engineers’ modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life. See how at www.cognizant.com The role is encouraged to drive technology discussions and analyze the current...
-
Medicaid Senior Insurance Manager
3 days ago
Indianapolis, IN, United States VirtualVocations Full timeA company is looking for a Medicaid Senior Insurance Product Manager to develop and manage Medicaid and Dual Eligible insurance products. Key Responsibilities Translate federal and state requirements to define health plan service packages Analyze industry trends to ensure competitive benefits and evaluate benefit performance for data-driven insights ...
-
Health Insurance Specialist
1 month ago
San Francisco, United States Centers For Medicare & Medicaid Services Full timeEstablishes Medicaid policy related to Medicaid Managed Care programs and other policy areas of responsibility that are located within the division. Advises on evaluating proposed new legislation and regulations to assess their impact on Medicaid prescription drug programs and Managed Care policies to enhance...
-
Medical Eligibility Coordinator
6 days ago
San Antonio, Texas, United States CommuniCare Health Center Full timeJob SummaryWe are seeking a highly skilled Medical Eligibility Specialist to join our team at CommuniCare Health Center. As a Medical Eligibility Specialist, you will play a critical role in ensuring that our patients receive the best possible care by facilitating their enrollment in various health programs and plans.Key ResponsibilitiesPerform new patient...
-
Senior Medicaid Technical Analyst
1 hour ago
, AR, United States NTT DATA Full timeAbout the RoleWe are seeking a highly skilled Senior Medicaid Technical Analyst to join our team in Little Rock, Arkansas. As a key member of our Business Operations Support team, you will work closely with state Medicaid Program staff and vendors to deliver high-quality solutions and support the analysis, planning, design, implementation, and evaluation of...
Medicaid Eligibility Specialist
4 months ago
Description
Mesa County Department of Human Services is a forward thinking agency that has over 300 employees serving the needs of nearly 40,000 residents. From the Colorado National Monument to the thriving agricultural lands and city centers, Mesa County contains a diverse, natural landscape that provides many outdoor activities and adventures. As individuals and an organization, we value and respect humanity, honesty, balance, inclusion and teamwork. We provide a level of flexibility for staff to be able to accommodate their lives outside of the office environment. We value family and the relationships that make our lives rewarding.
Our Mission:
The Mission of the Mesa County Department of Human Services is to help individuals and families achieve safety,stabilization and opportunity formeaningfulemployment.
Our Values:
Mesa County Department of Human Services values represent our behavioral anchors for how we conduct ourselves. Simply stated, we value Humanity, Balance, Honesty, Inclusion and Teamwork
JOB SUMMARY:
Performs eligibility work that requires a strong working knowledge and understanding of eligibility program rules and policies and operation of the current proscribed eligibility computer program(s). Performs duties associated with initial intake and ongoing eligibility determination for Medical Assistant Programs, as described in Colorado Staff Manuals, Volumes III, IVB, and VIII through the Department of Human Services or Department of Health Care Policy and Finance. Interprets rules and regulations of all program areas. Facilitates and/or coordinates the processes and procedures necessary to provide clients with assistance. Performs calculations and accounting functions necessary to establish eligibility and to determine the necessary steps to resolve client situations. Provides referral to other community resources to assist clients. Bilingual English / Spanish is a plus.
Essential Duties
ESSENTIAL JOB FUNCTIONS:
(The following duty statements are illustrative of the essential functions of the job and do not include other non-essential or marginal duties that may be required. Mesa County reserves the right to modify or change the duties or essential functions of this job at any time. All responsibilities may not be performed by all incumbents.)
Conducts initial and ongoing program eligibility interviews and assessments by phone, face-to-face and gathers information such as income and financial resources. Determines initial and ongoing eligibility for Medical Assistance Programs as described in Colorado Staff Manuals, Volumes III, IV-B, and VIII through the Department of Human Services or Department of Health Care Policy and Finance. Determines eligibility for Expedited Food Assistance.
Approves or denies applications, closes cases as necessary, and notifies clients of decisions in writing. Transfers cases to the appropriate eligibility specialist, team, or closed caseload.
Assists clients in completing forms and obtaining the necessary documentation for program participation. Assesses client needs and makes referrals to other agency and community services.
Screens applications to verify programs being applied for. Uses computerized systems to research current and past assistance status and history. Sets up new case files and properly categorizes household composition.
Maintains a working knowledge of the current proscribed eligibility computer system. Performs data entry functions to ensure that required and relevant information is accurately entered into
numerous complex data systems. Processes change forms for continued eligibility determination. As required, verifies all information through computer data banks, pay stubs, contacts with employers and banks, etc. Ensures benefit calculations made by the current proscribed eligibility computer program(s) are accurate in order to reduce/eliminate errors.
Manages workload and paper flow. Processes case changes as they occur. Ensures that all case documents are filed in the electronic case file appropriately and in a timely manner.
Completes required paperwork to restore benefits, provide retroactive payments, and provide supplements. Establishes and computes recoveries and restorations due as a result overpayment or underpayment; notifies fraud investigators when case information indicates that benefits may have been received based on fraudulent information.
Informs recipients/applicants of rules and regulations. Explains rights and responsibilities to clients and provides referrals to non-profit agencies and other service providers to facilitate a comprehensive solution to the client's issues.
Maintains a working knowledge of program rules and regulations. Receives, researches, resolves and clears information on required program reports.
Processes program sanctions. Identifies the level and kind of sanction. Provides sanction notification to the client being sanctioned.
Prepares cases for and attends dispute resolution conferences, appeals hearings, or other court cases in person or by telephone to represent the county and to testify to the facts of the case. Ensures documentation is detailed and clear in the case file.
Provides customer service by responding toinquiriesregarding programs and services. Handles client complaints and provides needed information regarding program guidelines.
Shall engage in heavy public contact via client interviews and front window coverage.
May be subject to vulgar, offensive language and behaviors from the public.
Based on workload, may be required to participate in mandatory overtime; such overtime may include evenings and weekends.
Responsible for understanding and demonstrating proficiency in all aspects of the eligibility position including but not limited to: face-to-face client meetings on a walk-in basis, lobby/client interviews, processing of applications and redeterminations, pulling and returning calls, working mail and any other correspondence submitted by clients.
