Medicaid Eligibility Specialist
4 weeks ago
Industry: Healthcare
FSLA status: Non-Exempt
Department: Operations
Location: Linthicum, MD and vicinity
Pay Rate: $23.05
At NTT DATA, we are committed to creating a diverse and inclusive environment for all employees. We are seeking a highly skilled Medicaid Benefits Eligibility Specialist to join our team for a 3-month temporary assignment or longer.
Job Summary:
The Medicaid Benefits Eligibility Specialist will work with and assist current Medicaid members to retain or renew their Medicaid eligibility and remain a member in the ABHMD Managed Care Organization (MCO) Plan. The successful candidate will be responsible for preventing or rectifying the disenrollment of members due to loss of their Maryland Medicaid eligibility.
Key Responsibilities:
- Ensure compliance with Medicaid enrollment regulations, Maryland Health Choice program policies, and procedures related to Maryland Medicaid HealthChoice and Maryland COMAR regulations.
- Notify members of their loss of eligibility in accordance with ABHMD Policies & Procedures.
- Conduct comprehensive evaluations of members using care management tools and information/data review.
- Coordinate with Primary Care Sites when working with members on loss of Maryland Medicaid eligibility.
- Develop a process for effectively identifying members with issues and communicating resolution of the issue.
- Provide coaching, information, and support to empower members to make ongoing independent medical and/or healthy lifestyle choices.
- Consult on matters regarding company policies, procedures, and practices.
- Monitor, evaluate, and document care.
- Utilize case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Qualifications:
- 3+ years of healthcare experience.
- 3+ years of experience working with Medicare/Medicaid.
- 2+ years of experience working with Medicaid eligibility requirements, enrollment, renewal, and redetermination related regulations and process.
- Associate's degree or equivalent experience.
About NTT DATA Services:
NTT DATA Services is a recognized leader in IT and business services, including cloud, data, and applications. We help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration, and global data centers. We are committed to our clients' long-term success.
Essential Functions:
All duties and responsibilities are essential job functions and are subject to possible modification to reasonably accommodate individuals with disabilities. Regular attendance is an essential function of this position.
Typical Physical Demands:
Requires sitting for long periods of time. Some bending, stretching, or reaching required. Requires the physical dexterity to operate a keyboard, calculator, telephone, copier, and other office equipment.
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Linthicum, MD, United States NTT DATA Full timeJob Title: Medicaid Benefits Eligibility Specialist (Temporary 3 months or longer) Industry: Healthcare FSLA status: Non-Exempt Department: Operations Location: Linthicum, MD and vicinity Pay Rate: $23.05 At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in...
