Remote Medicaid Eligibility Specialist II

Summary

Join our team at FreedomCare as a Medicaid Eligibility Specialist II in Georgia. This hybrid role involves verifying patient eligibility for Medicaid benefits, facilitating the approval process, and ensuring compliance with regulations. The ideal candidate will have experience in healthcare, insurance verification, or a related field, strong customer focus, and excellent communication skills.

Requirements

• Associate degree or higher in healthcare administration, business, or a related field preferred
• Minimum of 2 years of experience in healthcare, insurance verification, or a related field
• Experience with Medicaid verification and understanding of Medicaid regulations is highly preferred
• Proven track record of strong customer focus and adaptability in a high call volume environment (inbound and outbound)
• A passion for providing a high level of customer service, including the ability to show empathy, active listening and patience
• Effective written and verbal communication skills with the ability to engage with diverse audiences
• Ability to multitask, set priorities, and manage time effectively
• Technical proficiency with the ability to navigate through multiple systems; while maintaining attention to detail and data accuracy

Responsibilities

• Verify patient eligibility for Medicaid benefits using various online systems and tools
• Assist patient with preliminary review of documentation and requirements for application for Medicaid, ensuring all required documentation is complete and accurate
• Confirm coverage details and determine patient benefits and process based on Medicaid guidelines
• Investigate Medicaid issues related to eligibility, deferrals, denials and re-certifications through contact with the Patient or Patient representative to identify the cause of eligibility related issues and offering recommendations for resolution
• Maintain accurate and detailed records of verification processes and outcomes
• Update patient records in Salesforce to reflect current Medicaid status
• Serve as a point of contact for Medicaid inquiries from clients, caregivers, and Health plan partners
• Assist clients in understanding Medicaid eligibility, benefits, and application processes
• Advocate for clients to ensure they receive appropriate Medicaid services
• Respond to inquiries from patients and healthcare providers regarding Medicaid coverage and eligibility

Benefits

• Competitive compensation
• Medical benefits
• Retirement plans
• Wellness programs