[Hiring] Medicaid Eligibility Specialist @Conduent
Role Description
As part of the KanCare Clearinghouse Program, the Transaction Processing Associate III (ES) will perform a variety of duties. The position is responsible for gathering thorough documentation and entering information into various systems.
• Analyze the initial applications and reviews (for Family Medical programs) and supporting documentation provided by applicants to determine eligibility for federal and state medical assistance.
• Investigate the applicant circumstances through the use of available computer systems (Databases, registries, and informational deposits) researching records provided by the applicant and their contacts to provide information about household income, resources, and expenses for eligibility determination.
• Enter household information and authorize eligibility within the Kansas Economic and Enforcement System (KEES).
• Complete determinations using State and Federal regulations to determine eligibility for medical benefits based on financial and non-financial criteria.
• Document the eligibility decision in the electronic case journal and send appropriate system-based and manual correspondence to customers and representatives explaining the results of the eligibility determination and information regarding appeal rights.
• Make outbound calls, based on established policy, to verify or obtain missing information when documentation is incomplete.
• Use knowledge of State eligibility processes, policies, and procedures governing managed care enrollment to communicate with consumers regarding various issues.
• Attend training as assigned to develop and enhance understanding of Kansas Medicaid eligibility programs.
• Maintain up-to-date knowledge of regulations, policies, and guidelines.
Qualifications
• Knowledge of Medicaid and managed care programs.
• Minimum of two (2) years’ experience in determining Long-Term Care, Elderly and Disabled, or Family Medical eligibility.
• Successfully complete KDHE Eligibility Training and sandboxing.
• Ability to manage competing priorities.
• Demonstrated critical thinking skills.
• Good interpersonal and communication skills both verbally and in writing, including knowledge of basic grammar, spelling & punctuation.
• Willingness to work as part of a team.
• Maintain the integrity and confidentiality of all records and communications.
• Bilingual Spanish/English with the ability to speak and read both languages fluently.
Requirements
• High School diploma or GED equivalent; post-secondary education preferred.
• Strong computer skills with the ability to maneuver in complex software systems.
• Excellent data entry skills with the ability to type 28-30 minutes per minute accurately.
• Experience with MS Office, Outlook, and Internet usage.
Benefits
• Health insurance coverage.
• Voluntary dental and vision programs.
• Life and disability insurance.
• Retirement savings plan.
• Paid holidays.
• Paid time off (PTO) or vacation and/or sick time.
As part of the KanCare Clearinghouse Program, the Transaction Processing Associate III (ES) will perform a variety of duties. The position is responsible for gathering thorough documentation and entering information into various systems.
• Analyze the initial applications and reviews (for Family Medical programs) and supporting documentation provided by applicants to determine eligibility for federal and state medical assistance.
• Investigate the applicant circumstances through the use of available computer systems (Databases, registries, and informational deposits) researching records provided by the applicant and their contacts to provide information about household income, resources, and expenses for eligibility determination.
• Enter household information and authorize eligibility within the Kansas Economic and Enforcement System (KEES).
• Complete determinations using State and Federal regulations to determine eligibility for medical benefits based on financial and non-financial criteria.
• Document the eligibility decision in the electronic case journal and send appropriate system-based and manual correspondence to customers and representatives explaining the results of the eligibility determination and information regarding appeal rights.
• Make outbound calls, based on established policy, to verify or obtain missing information when documentation is incomplete.
• Use knowledge of State eligibility processes, policies, and procedures governing managed care enrollment to communicate with consumers regarding various issues.
• Attend training as assigned to develop and enhance understanding of Kansas Medicaid eligibility programs.
• Maintain up-to-date knowledge of regulations, policies, and guidelines.
Qualifications
• Knowledge of Medicaid and managed care programs.
• Minimum of two (2) years’ experience in determining Long-Term Care, Elderly and Disabled, or Family Medical eligibility.
• Successfully complete KDHE Eligibility Training and sandboxing.
• Ability to manage competing priorities.
• Demonstrated critical thinking skills.
• Good interpersonal and communication skills both verbally and in writing, including knowledge of basic grammar, spelling & punctuation.
• Willingness to work as part of a team.
• Maintain the integrity and confidentiality of all records and communications.
• Bilingual Spanish/English with the ability to speak and read both languages fluently.
Requirements
• High School diploma or GED equivalent; post-secondary education preferred.
• Strong computer skills with the ability to maneuver in complex software systems.
• Excellent data entry skills with the ability to type 28-30 minutes per minute accurately.
• Experience with MS Office, Outlook, and Internet usage.
Benefits
• Health insurance coverage.
• Voluntary dental and vision programs.
• Life and disability insurance.
• Retirement savings plan.
• Paid holidays.
• Paid time off (PTO) or vacation and/or sick time.