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Mfinite Consulting LLC
Medical Care Program Associate II (Eligibility Determination Associate)
Baltimore, MD
about 1 month ago
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Summary
Location: Baltimore, MD (Onsite)
Employment Type: Full-Time
Salary: Competitive, Based on Experience
About Mfinite Consulting
Mfinite Consulting LLC is a certified professional services firm providing customized solutions in management consulting, IT support, and staffing. We specialize in strengthening organizations through enhanced workforce capabilities and operational improvements.
Job Summary
Mfinite Consulting is seeking Medical Care Program Associate II (Eligibility Determination Associates) to support Medicaid eligibility operations for the Maryland Department of Health (MDH). The primary responsibility of this role is to review, verify, and process Medicaid applications by interpreting and applying federal and state regulations to determine applicant eligibility.
Key Responsibilities
Accurately determine Medicaid eligibility for Non-MAGI and MAGI applications with a 96% accuracy rate.
Conduct document verification, financial assessments, and data reviews to ensure compliance.
Communicate with applicants and authorized representatives to gather missing information.
Update data systems timely and accurately to reflect eligibility decisions.
Identify and resolve discrepancies affecting Medicaid services or provider payments.
Ensure adherence to Maryland Health Connection (MHC), MMIS, Beacon, and other Medicaid data systems.
Maintain compliance with HIPAA and state confidentiality laws when handling sensitive information.
Provide recommendations to improve processes and enhance customer service.
Qualifications & Experience
Education: High school diploma or equivalent required. College credits may substitute for experience (30 credits = 1 year).
Experience:
Minimum of two (2) years of clerical experience in medical care, health insurance, or state/federal entitlement programs.
Minimum of two (2) years working in an office or customer service environment handling document reviews and data system updates.
Skills:
Proficiency in Google Suite, Microsoft Office (Excel, Word, Outlook).
Ability to navigate state Medicaid data systems effectively.
Strong analytical, problem-solving, and communication skills.
Detail-oriented with the ability to adapt to policy updates and procedural changes.
Work Schedule & Conditions
Full-time position (40 hours/week) Permanent Day Shift.
General supervision with structured training provided.
Onsite role at 6 St. Paul St., Baltimore, MD 21202.
Why Join Mfinite Consulting?
Opportunity to contribute to a critical public health initiative in Maryland.
Competitive compensation and career growth opportunities.
Work with an experienced and mission-driven team in a collaborative environment.
How To Apply
Interested candidates should submit their resume and cover letterthrough the portal.
Mfinite Consulting is an equal opportunity employer committed to fostering diversity and inclusion in the workplace.
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