Enkaare

Medicaid Eligibility staff at the Medical Care Program Associate II

Baltimore, MD, US

14 days ago
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Summary

Company Description

Enkaare is a Recruitment, Staff Augmentation, and Consulting Company that specializes in providing remote, onsite and hybrid talent in the healthcare, local government and tech indutries.


Role Description

This is a full-time, but temporary role for a Medicaid Eligibility staff as a Medical Care Program Associate II.

The primary function of the Eligibility Determination Associate (Medical Care Program Associate I and II is to accurately interpret, analyze, and apply federal and State Medicaid regulations and policies when reviewing and verifying Non-MAGI and MAGI Medicaid applications, verifications, and data to render eligibility determinations.


Eligibility Determination Associate are responsible for accurately reviewing and verifying verifications including but not limited to applications, technical verifications, income, asset, resource, financial verifications, and clearances for accuracy, completeness, and compliance prior to rendering an eligibility decision. Additionally, the review and verification process may encompass contact with applicants, recipients, or authorized representatives to secure missing eligibility verifications required to render accurate eligibility decisions.  


The Eligibility Determination Associate is also responsible for ensuring all data systems are updated timely and accurately this includes ensuring verifications are uploaded when applicable. The Associate must also take appropriate actions to resolve data discrepancies that impact a recipient’s ability to obtain services and/or provide payment.  


Qualifications

  • Strong Communication skills
  • Experience in Human Services
  • Customer Service skills
  • Knowledge of Medicaid and Insurance processes
  • Ability to work independently (and remotely if required and allowed)
  • Proficiency in relevant software and documentation processes
  • Bachelor's degree in Healthcare Administration, Social Work, or a related field is a plus

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