The Medicaid Enrollment Specialist focuses on successfully enrolling prospective participants in Medicaid.
Responsibilities
Gather all necessary documentation to create, submit, doggedly pursue, and appeal Medicaid enrollments for prospective participants
Visit senior's homes as needed to gather necessary documentation to submit complete applications
Maintain a strong working relationship with the Department of Public and Social Services (DPSS) at the county to ensure seamless enrollment workflow, adhere to deadlines and ensure compliance with DHCS and CMS guidelines and policies
Create and conduct Medicaid enrollment events to attract prospective participants
The Participant Benefits Specialist is responsible for managing and maintaining participant Medicaid and Medicare eligibility, ensuring accurate documentation, compliance, and timely renewals across multiple states.
Responsibilities
Assist participants and caregivers with Medicaid and Medicare applications, renewals, appeals and eligibility updates
Navigate state-specific systems to ensure timely and accurate benefit qualification for PACE program
Maintain and update Medicaid renewal trackers, Medicare trackers, presumptive eligibility and termination logs monthly
Conduct weekly reviews in Medicaid and Medicare portals or reports to identify new terminations and verify all active participants reflect PACE coverage
Coordinate with Social Workers on necessary spenddowns for renewals and communicate updates to the team
Requirements
High school diploma
Associates or Bachelor’s degree in Human Services, Business, or a related field preferred
Gather all necessary documentation to create, submit, doggedly pursue, and appeal Medicaid enrollments for prospective participants.
Responsibilities
Gather all necessary documentation to create, submit, doggedly pursue, and appeal Medicaid enrollments for prospective participants
Visit seniors’ homes as needed to gather necessary documentation to submit complete applications
Maintain a strong working relationship with the Department of Public and Social Services (DPSS) at the county to ensure a seamless enrollment workflow, adhere to deadlines, and ensure compliance with DHCS and CMS guidelines and policies
Create and conduct Medicaid enrollment events to attract prospective participants
Participant Benefits SpecialistAcuteCare Health System LLC · Holly Hill, US
Medicaid Enrollment SpecialistExpertHiring · Newark, US