Medicaid Eligibility Specialist

2 weeks ago

Goldsboro, North Carolina, United States UNC Health Full time
Medicaid Eligibility Specialist Job Summary

Become part of a dynamic organization dedicated to improving the health and well-being of diverse communities. As a Medicaid Eligibility Specialist at UNC Health, you will play a vital role in facilitating the Medicaid application process for patients who meet the eligibility criteria.

Key Responsibilities:
  • Screen and coordinate Medicaid applications across multidisciplinary entities.
  • Evaluate patient cases for potential eligibility and obtain Medicaid benefits for patients entitled to reimbursement.
  • Perform thorough interviews and analyze patient assets, income, clinical history, and dependent responsibilities.
  • Communicate complex financial concepts and procedures to patients.
  • Act as authorized patient representatives for Medicaid application initiation and appeals processes.
  • Gather and provide necessary verification for Medicaid eligibility.
  • Initiate Medicaid application processes within designated deadlines.
  • Complete and submit required documentation, including Medicaid applications and NCDHHS forms.
  • Follow up with patients and Department of Social Services to ensure all pertinent information is provided.
  • Represent patients in challenges, including denials and unsatisfied approvals, and facilitate requests for hearings.
  • Present patient cases, examine witnesses, and enter evidence into case files at adjudication hearings.
  • Enter pertinent information into EPIC and monitor authorized Medicaid approval dates.
  • Provide financial assistance referrals and information to patients.
  • Maintain accounts in Epic Work Queues and complete all documentation.
Requirements:
  • High School graduate or equivalent required.
  • Prior experience with Medicaid administration in social services or healthcare organizations is strongly preferred.
  • Demonstrated analytical, customer service, and interpersonal skills.
  • Strong organizational skills and attention to detail.
  • Ability to prioritize and multitask, with good communication skills.
  • Proficient with MS Office and Epic, with the ability to learn new software rapidly.
UNC Health Values:

We are committed to providing exceptional patient care and improving the health and well-being of our communities. As a Medicaid Eligibility Specialist, you will be part of a team that values diversity, inclusivity, and excellence in all aspects of our work.

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