Medicaid Eligibility Specialist

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.

Medicaid Eligibility Specialist

Position is remote and individual must reside in Kansas

Start date - Early August, tentatively August 10th

Hours: 8 – 4:30 pm CST

Training length:  approximately 10 weeks to include sandboxing

• Transaction Processing Associate III Bilingual - $17.75/hr

• Transaction Processing Associate III $17.25/hr

Job Description:

As part of the KanCare Clearinghouse Program, the Medicaid Eligibility Specialist will perform a variety of duties. The position is responsible for gathering thorough documentation and entering information into various systems 

Essential duties may include, but are not limited to:

• 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 thorough the use of available computer systems (Databases, registries, and informational deposits) researching records provided by the applicant and their contacts to provide the information about the household income, resources, and expenses upon which the eligibility determination is made.

• Entering household information and authorizing eligibility within the Kansas Economic and Enforcement System (KEES). Professional completes 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. 

• Eligibility Professional may be required to make outbound calls, based on established policy, to verify or obtain missing information when documentation is incomplete and the information can be resolved via telephone contact.

• Eligibility Professionals are expected to use knowledge of State eligibility processes, policies, and procedures governing managed care enrollment to communicate with consumers regarding a variety of issues.

• Attend training as assigned to develop and enhance current understanding of Kansas Medicaid eligibility programs.  Through training and experience, develop expertise in additional areas of determination categories.

• Maintain with up-to-date knowledge of regulations, policies, and guidelines.

Preferred Skills or Knowledge:

• 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

• Must possess 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

• All other duties as assigned.

• Bilingual Spanish/English with the ability to speak and read both languages fluently.

Minimum Qualifications/Experience

• High School diploma or GED equivalent; post-secondary education preferred

• Strong computer skills with the ability to maneuver in complex software systems

• Requires excellent data entry skills the ability to type 28-30 minutes per minute accurately

• MS Office, Outlook, and Internet usage experience

Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information.  For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated hourly rate for this role is $17.25.

Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.

For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded:   click here to access or download the form .  Complete the form and then email it as an attachment to  View email address on careers.conduent.com . You may also  click here to access Conduent's ADAAA Accommodation Policy .