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.
• 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.
#INDHRS
Benefits Specialist- Medicaid Eligibility Specialist at NTT DATA summary:
The Benefits Specialist - Medicaid Eligibility Specialist is responsible for assisting members in retaining or renewing their Medicaid eligibility within the ABHMD Managed Care Organization in Maryland. This position involves ensuring compliance with Medicaid regulations, notifying members of eligibility changes, and maintaining accurate documentation in Members' electronic records. Additionally, the specialist cultivates relationships with healthcare partners and engages in tracking member interactions to facilitate effective communication and resolution of eligibility issues.
Keywords:
Medicaid eligibility, healthcare compliance, Medicaid renewal, member support, customer service, eligibility specialist, healthcare enrollment, Maryland Medicaid
