Eligibility Professional

4 weeks ago

Topeka, United States Conduent Full time
Job Description

Hourly Rate - $17.25/hr Bilingual $17.75/hr

Job Description:

As part of the KanCare Clearinghouse Program, the Eligibility Professional Specialist will perform a variety of duties. The position is responsible for gathering thorough documentation and entering information into various systems

Essential duties may include, but are not limited to:
  • Analyze the initial applications and reviews (for Family Medical programs) and supporting documentation provided by applicants to determine eligibility for federal and state medical assistance. Investigate the applicant circumstances thorough the use of available computer systems (Databases, registries, and informational deposits) researching records provided by the applicant and their contacts to provide the information about the household income, resources, and expenses upon which the eligibility determination is made.
  • Entering household information and authorizing eligibility within the Kansas Economic and Enforcement System (KEES). Professional completes determinations using State and Federal regulations to determine eligibility for medical benefits based on financial and non-financial criteria. Document the eligibility decision in the electronic case journal and send appropriate system-based and manual correspondence to customers and representatives explaining the results of the eligibility determination and information regarding appeal rights.
  • Eligibility Professionals are expected to use knowledge of State eligibility processes, policies, and procedures governing managed care enrollment to communicate with consumers regarding a variety of issues.
  • Attend training as assigned to develop and enhance current understanding of Kansas Medicaid eligibility programs. Through training and experience, begin to develop expertise in additional areas of determination categories.
  • Maintain with up-to-date knowledge of regulations, policies, and guidelines.
Preferred Skills or Knowledge:
  • Knowledge of Medicaid and managed care programs
  • Ability to manage competing priorities
  • Demonstrated critical thinking skills
  • Must possess good interpersonal and communication skills both verbally and in writing including knowledge of basic grammar, spelling & punctuation
  • Requires excellent data entry skills the ability to type 28-30 minutes per minute accurately
  • Willingness to work part of a team
  • Maintain the integrity and confidentiality of all records and communications
  • All other duties as assigned.
  • Bilingual Spanish/English with the ability to speak and read both languages fluently.
Qualifications/Experience
  • High School diploma or GED equivalent; post-secondary education preferred
  • Preferred two (2) years' experience in determining Long-Term Care, Elderly and Disabled, or Family Medical eligibility
  • Successfully complete KDHE Eligibility Training
  • Strong computer skills with the ability to maneuver in complex software systems
  • Intermediate level of skill with MS Office, Outlook, and Internet usage


Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information. For this position, 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. In addition, 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 pay for this role is $17.25 per hour.

About Us

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.

About the Team

Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.

People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the "Submit" button at the bottom of the form. For those using Google Chrome or Mozilla Firefox please download the form first: click here to access or download the form. You may also click here to access Conduent's ADAAA Accommodation Policy.
At Conduent we value the health and safety of our associates, their families and our community. For US applicants while we DO NOT require vaccination for most of our jobs, we DO require that you provide us with your vaccination status, where legally permissible. Providing this information is a requirement of your employment at Conduent.

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