Healthcare Eligibility Specialist

2 weeks ago

Olympia, Washington, United States State of Washington Full time


Position Overview:


The Healthcare Eligibility Specialist plays a vital role in ensuring that eligible individuals receive access to essential medical services. This position is integral to the operations of the Medicaid Customer Service division, which collaborates with various stakeholders to deliver high-quality health care programs.


Key Responsibilities:


As a Healthcare Eligibility Specialist, you will:

  • Conduct thorough analyses of applications to determine eligibility for Medicaid and related programs.
  • Apply complex federal and state regulations to assess individual household circumstances accurately.
  • Utilize various electronic systems to manage client information and eligibility records.
  • Engage with clients through interviews and correspondence to gather necessary documentation for eligibility verification.
  • Collaborate with healthcare providers and community organizations to resolve eligibility inquiries and facilitate access to services.

Qualifications:


To be considered for this role, candidates must meet one of the following criteria:

  • A bachelor's degree and one year of relevant experience.
  • An associate degree and three years of relevant experience.
  • A certificate in Medical Billing and Coding or a related field and three years of relevant experience.
  • Five years of relevant experience in client services or eligibility determination.

Preferred Skills:


Ideal candidates will possess:

  • Experience in conflict resolution and customer service.
  • Knowledge of Medicaid programs and eligibility criteria.
  • Proficiency in Microsoft Office applications.

Work Environment:


This position offers flexibility, including the potential for remote work arrangements. The primary work location is within the State of Washington, with varying onsite requirements based on operational needs.


About the Organization:


The Washington State Health Care Authority is committed to enhancing the health and well-being of its residents through effective health care purchasing and behavioral health services. The agency prioritizes a diverse and inclusive workplace, fostering an environment where all employees can thrive.

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