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Eligibility Specialist II
2 months ago
We are seeking a highly skilled Eligibility Specialist II to join our team at the City of New York. As a Medicaid Eligibility Specialist, you will play a critical role in determining eligibility for Medicaid coverage for applicants and recipients.
Key Responsibilities- Conduct comprehensive reviews of applications, including financial and legal documentation, to determine eligibility for Medicaid coverage.
- Perform budget calculations, obtain clearance reports, and resolve resource matches using various systems, including EDITS, WMS, and eMedNY.
- Determine eligibility for the appropriate level of Medicaid coverage for MAGI and Non-MAGI applicants and recipients.
- Prepare eligibility forms and notices to inform applicants and recipients of case disposition.
- Interview and/or review documentation submitted by applicants and recipients or authorized representatives to determine eligibility for Medicaid.
- Respond to inbound and outbound telephone calls from clients and/or authorized representatives with inquiries related to Medicaid coverage.
- Assist consumers who need further assistance in understanding the eligibility criteria for the Excess Income Program.
- Completion of 30 semester credits at an accredited college or university; or
- A four-year high school diploma or its educational equivalent and one year of full-time satisfactory experience in one or more of the following areas:
- Interviewing, gathering information, and/or preparing necessary documentation for eligibility determinations.
- Performing bookkeeping, bank teller duties, or customer service duties.
- Dealing with social service agencies, legal representatives, or aiding individuals in navigating housing, social, financial, or health problems.
- A satisfactory combination of education and/or experience equivalent to the above.
The City of New York is an inclusive equal opportunity employer committed to recruiting and retaining a diverse workforce and providing a work environment that is free from discrimination and harassment based on any legally protected status or protected characteristic.
