Benefits Specialist II

4 weeks ago


Linthicum Heights, Maryland, United States US Tech Solutions Full time
Job Summary:

As a Benefits Consultant II at US Tech Solutions, you will play a crucial role in ensuring compliance with Medicaid enrollment regulations and related Maryland HealthChoice program policies and procedures. Your primary responsibility will be to assure adherence to and understanding of these regulations, ensuring that members are notified of their loss of eligibility in accordance with established policies and procedures.

Key Responsibilities:

  • Collaborate with primary care site partners, FQHCs, and community-based outreach/enrollment organizations to engage their assistance in working with members to maintain their Maryland Medicaid eligibility and correct information.
  • Coordinate with Primary Care Sites when working with members on loss of Maryland Medicaid eligibility.
  • Thoroughly log all member-related interactions into Salesforce for accurate tracking and analysis.
  • Develop a process for effectively identifying members with issues and communicating resolution of the issue.
  • Complete a Weekly Status Report for Supervisor and ABHMD Managers.
  • Offer recommendations for improvements in ABHMD practices to enhance service delivery and member satisfaction.
  • Participate in ABHMD-sponsored meetings and events.
  • Represent ABHMD in the community, when requested, and provide other duties as assigned.

Requirements:

  • Associate's Degree or equivalent experience.
  • Minimum 3-5 years of experience in healthcare, with a focus on Medicaid/Medicare program operations.
  • 2+ years' experience specifically with Medicaid policy, financing, program operations, business requirement development, or systems.
  • 1+ years' experience working with Medicaid eligibility requirements, as well as enrollment, renewal, and redetermination-related regulations and processes.

About US Tech Solutions:

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. We are committed to providing equal opportunities for all qualified applicants and strive to create a diverse and inclusive work environment.



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