Medicaid Eligibility Specialist
2 weeks ago
We are seeking highly motivated and detail-oriented individuals to join our team as Eligibility Specialists II, functioning as EIS Case Reviewers. As a key member of our team, you will be responsible for reviewing Medicaid applications, conducting interviews, and determining eligibility for Medicaid benefits.
Key Responsibilities- Respond to client inquiries and provide information on Medicaid coverage, including the Excess Income Program and A/Rs responsibility towards the cost of their care.
- Interview and review documentation submitted by applicants/recipients to determine eligibility for Medicaid.
- Conduct comprehensive reviews of applications, including financial and legal documentation, as well as paid or unpaid medical bills.
- Determine eligibility for the appropriate level of Medicaid coverage for MAGI and Non-MAGI A/Rs.
- Assist consumers who need further assistance in understanding the eligibility criteria to qualify for the Excess Income Program.
- Prepare eligibility forms and notices to inform A/Rs of case disposition.
- Prepare daily activity logs of cases completed for submission to the supervisor.
- 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:
- a. Interviewing, gathering information, and/or preparing necessary documentation for the purpose of making recommendations concerning eligibility for public assistance or unemployment, health benefits, social security, insurance, or participation in social services or community programs, and other similar benefits;
- b. Performing bookkeeping, bank teller duties, housing office teller duties, purchasing agent, assistant store manager, sales representative responsible for accounts, or customer service duties or a job in which the duties include helping customers with questions or concerns;
- c. Dealing with social service agencies, legal representatives, or aiding individuals in navigating housing, social, financial, or health problems or application systems;
- A satisfactory combination of education and/or experience equivalent to 1 or 2 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 upon any legally protected status or protected characteristic, including but not limited to an individual's sex, race, color, ethnicity, national origin, age, religion, disability, sexual orientation, veteran status, gender identity, or pregnancy.
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