Details Below:
POSITION : EligibilitySpecialist-Medicaid (Maryland)
LOCATION : Onsite-Linthicum, MD
JOB TYPE : Contract
PAY: $21.70 per hour
HOURS: M-F 8:30am-5:00pm
START DATE: 11/18/2024.
Medicaid Eligibility Retention Specialist to work with and assist current members to retain or renew their Medicaid eligibility and remain a member in the ABHMD Managed Care Organization (MCO) Plan, by preventing or rectifying the disenrollment of members due to loss of their Maryland Medicaid eligibility.
Key Responsibilities
• Understand, and assure compliance to and adherence with, the Medicaid enrollment regulations, and related Maryland HealthChoice program policies and procedures related to Maryland HealthChoice member eligibility redetermination and renewals polices.
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• Notify members, in accordance with ABHMD Policies & Procedures (which reflect Maryland Medicaid HealthChoice and Maryland COMAR regulations) of their loss of eligibility.
• Ensure copies of notices and documentation are filed in Members' electronic records.
• Cultivate and maintain collaborative relationships - with primary care site partners, FQHC and community based outreach/enrollment organizations - to engage their assistance in working with members to maintain their Maryland Medicaid eligibility and correct information.
• Coordinate with Primary Care Sites when working with members on loss of Maryland Medicaid eligibility.
• Thoroughly log all member related interactions into Salesforce for the purpose of accurate tracking and analysis.
• Develop a process for effectively identifying members with issues and communicating resolution of the issue.
• Complete a Weekly Status Report for Supervisor and ABHMD Managers.
Minimum Qualifications
• Associate's Degree or equivalent experience.
• 3-5 years Eligibility Experience
• 3+ years of Medicaid programs experience
• Experience working with Medicaid eligibility requirements, as well as enrollment, renewal and redetermination related regulations and process.
• Experience in customer service, specifically working with low-income and culturally diverse populations or, Medicaid enrolled or eligible individuals in person and on the phone.
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