Eligibility Specialist III

2 weeks ago


WinstonSalem, United States Forsyth County (North Carolina) Full time

The Department of Social Services seeks a highly motivated and dependable professional to join our Medicaid team. This role requires advanced communication and exceptional customer service skills to support the Medicaid and Economic Services Divisions. This position requires the ability to work in a fast-paced, evolving environment. Sometimes, one may have to train in different locations. Also, due to the agency's needs, this position may call for overtime. Graduation from high school or GED and two (2) years of experience as an Eligibility Specialist or Income Maintenance Caseworker or closely related experience in the following programs: Childcare Subsidies, Adult Medicaid, Family and Children's Medicaid, Energy, Medicaid Transportation, Food and Nutrition, Program Integrity, and Work First. A higher education level may be considered as a substitution for all or part of the experience requirement. Required: Two years or more experience as an Eligibility Specialist or Income Maintenance Caseworker and two years' experience with NCFAST. Valid driver's license required. The successful candidate will conduct and process local, state, and program integrity hearings and appeals related to Medicaid services for the Forsyth County Department of Social Services. Additionally, this individual will support the current Hearing Officer for Economic Services, assisting with daily operations, scheduling, and conducting local and state hearings. As a liaison between the State of North Carolina’s Hearing and Appeals sections and the Department of Social Services, the candidate will review appeal submissions and collaborate effectively to ensure accurate and timely processing. The candidate will also hear cases and make informed decisions regarding eligibility determinations for denied or terminated applications, recertifications, or approved applications with limited coverage. The successful candidate must be able to: Interpret complex rules and regulations and use good judgment to make appropriate eligibility decisions. Have exceptional organizational skills. Work independently. Perform basic mathematical calculations. Work quickly within deadlines. #J-18808-Ljbffr



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