What are the responsibilities and job description for the Medicare/Medicaid Eligibility Specialist - Fully Remote! position at Centauri Health Solutions?
Role Overview:
The Medicare/Medicaid Eligibility Specialist works with health plan members to determine eligibility for Social Security disability benefits. The Medicare/Medicaid Eligibility Specialist advocates and assists Medicare beneficiaries apply to and requalify for government assistance programs. The Medicare/Medicaid Eligibility Specialist builds trusting relationships with members provide critical application assistance.
Role Responsibilities:
Conducts telephonic outreach activities for members who need to apply or recertify and are potentially eligible for various Medicaid programs including the Medicare Savings Programs
Collaborates with government offices to accurately complete the application and recertification process
Secures documentation for Medicaid/MSP renewal applications if needed for members
Attention to detail by adhering to state requirements and securing supporting documentation
Meets daily, weekly, and monthly production goals. Must also meet quality standards by ensuring proper phone etiquette and adherence to scripts, state regulations, HIPAA compliance, meet ongoing corporate compliance standards, and make accurate and descriptive documentation
Participates as required in operational development programs
Research changes with any state and federal regulatory requirements to adhere to strict compliance of all aspects of Medicare programs and Medicaid Outreach Operations
Demonstrates behaviors, actions, and attitudes that reflect our vision, mission and values
Understand and agree to role-specific information security access and responsibilities
Ensure safety and confidentiality of data and systems by adhering to the organizations information security policies
Read, understand and agree to security policies and complete all annual security and compliance training
Role Requirements:
Medicare/Medicaid program experience, and experience with screening for Medicaid eligibility a strong plus
Expertise and knowledge of Medicaid, Special Needs Programs (SNP), Low Income Subsidy (LIS) and the Medicare Savings Program (MSP)
Strong working knowledge with Microsoft Office programs, and some experience with Excel.
Excellent oral communication skills; ability to communicate with elderly individuals and governmental personnel
2-3 years related experience with direct consumer interaction
Outstanding customer service and communication skills
Strong organizational, analytical, critical thinking and customer service skills
Ability to analyze and interpret governmental program criteria
Ability to manage a fast-paced environment
Must be able to navigate through multiple databases/monitors with a minimum typing speed of 45 wpm
Telephone experience and ability to interact and decipher information via telephonic or correspondence inquires
Strong subject matter expertise of Medicaid programs regulations and industry standards
Case management experience or related experience / intermediate
A compassionate and empathetic nature with a strong desire to help and make a difference
Bachelor’s or Associate’s Degree a plus
Salary : $17 - $20