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  • 1457 East 40th Street
    Cleveland, Ohio, OH 44103

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Medicaid/Medicare Eligibility Specialist

Centauri Health Solutions, Inc. • Cleveland, Ohio, OH

Posted 5 days ago

Job Snapshot

Full-Time
Travel - None
Experience - At least 2 year(s)
Degree - High School
Healthcare - Health Services
Health Care

Job Competition

21

Applicants

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Job Description

As a Medicare/Medicaid Eligibility Specialist you will advocate and assist low-income Medicare beneficiaries enrolled in a contracted health plan in the application and eventual re-qualification for government assistance programs.

This will require you to project empathy over the phone to gain the applicant’s trust and gain their consent for us to provide application assistance. You will then provide program qualification and application expertise to the applicant and manage outreach to government offices that process and adjudicate applications.

The person performing this role must have a strong working knowledge of program qualification requirements spanning 50 states, 3 territories and hundreds of counties specific to Medicaid, Special Needs Programs (SNP), Low Income Subsidy (LIS) and the Medicare Savings Program (MSP).

Join our award-winning health care services firm as a Medicare/Medicaid Eligibility Specialist working with health plan members to determine eligibility for Social Security disability benefits. The Medicare/Medicaid Eligibility Specialist advocates and assists low-income Medicare beneficiaries apply to and requalify for government assistance programs.

 

The Medicare/Medicaid Eligibility Specialist projects empathy over the phone and gains the required trust and consent to provide application assistance. The Medicare/Medicaid Eligibility Specialist provides program qualification/application expertise and manages outreach to government offices.

 

We offer a vibrant, positive team culture with a focus on customer service and professional growth. We make a difference in the lives of our customers, our community, and our associates. In fact, our service vision is “Come from a place of kindness in every interaction.” If that aligns with your personal values, your qualifications meet our requirements, and you are interested in our Medicare/Medicaid Eligibility Specialist role, we would love to talk!

 

About the Centauri Health Solutions Environment

 

We believe strongly in providing employees a rewarding work environment in which to grow, excel and achieve personal as well as professional goals. We offer our employees competitive compensation and a comprehensive benefits package that includes generous paid time off, a matching 401(k) program, tuition reimbursement, annual salary reviews, a comprehensive health plan, and paid volunteer time.

 

About Centauri Health Solutions

 

We help hospitals and health plans improve their revenue and deliver community benefit. On their behalf, we help their patients and plan members with low or no income, and those who are aged or disabled, to enroll in government-funded assistance programs and realize quality-of-life improvements. Leveraging unmatched experience in program eligibility with the latest technologies, our dedicated, compassionate professionals yield results that exceed customer expectations. We have positively impacted the lives of millions of people and added billions of dollars to our nation’s healthcare economy. To learn more about our organization, please visit our websites: Centaurihs.com and HumanArc.com.

 

The Medicare/Medicaid Eligibility Specialist will possess strong working knowledge of program qualification requirements spanning 50 states, 3 territories and hundreds of counties specific to Medicaid, Special Needs Programs (SNP), Low Income Subsidy (LIS) and the Medicare Savings Program (MSP).

 

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.
  • Performs other duties as assigned.

Education:

  • Bachelor’s degree or Associate diploma with 2-3 years related experience with direct consumer interaction, telephone experience and Medicare/Medicaid program experience.

Job Type: Full-time

 

Centauri Health Solutions is an equal opportunity employer.

Job Requirements

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.
  • Performs other duties as assigned.
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