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Eligibility Specialist II
2 months ago
The State of South Carolina is seeking a highly skilled Eligibility Specialist II to play a critical role in determining and re-determining Medicaid eligibility according to Medicaid policies and procedures.
Key Responsibilities- Collect and evaluate documentation from applicants to determine individual and family eligibility for the program.
- Complete all assigned eligibility determinations, reviews, and changes in an accurate and timely manner.
- Utilize various information sources, electronic tools, and systems provided by the Department to collect, assemble, evaluate, and act upon information provided by applicant/beneficiaries and third parties.
- Follow policies and procedures for the collection and analysis of applications and documentation.
- Perform follow-up activities in an efficient and effective manner.
- Document all notes and steps clearly and completely for review and hand-off to other specialists.
- A high school diploma and experience in customer services, social services, human services, and/or Medicaid processing.
- A bachelor's degree may be substituted for the required program experience.
- Additional Requirements:
- Overtime and/or weekend work with Deputy approval.
- Sitting or standing for long periods of time.
- Lifting requirements: 20 lbs.
- Occasional overnight travel.
- Familiarity with computers, standard Microsoft Office software, internet browsers, and the ability to read, write, and speak English in a clear and concise manner.
- Ability to perform basic mathematical computations.
- Excellent customer service skills.
- Ability to learn, retain, and apply information about federal rules and standards for processing Medicaid eligibility determinations.
- Ability to maintain productive workspaces and perform tasks in an effective manner to ensure the completeness, accuracy, and timeliness of eligibility determinations.
- Health, dental, vision, long term disability, and life insurance for employee, spouse, and children.
- 15 days annual (vacation) leave per year.
- 15 days sick leave per year.
- 13 paid holidays.
- State retirement plan and deferred compensation programs.
The State of South Carolina is committed to providing equal employment opportunities to all applicants and does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, or genetic information.
