Medicaid Eligibility Specialist (Hybrid)

Medicaid Eligibility Specialist (Hybrid)

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.

We're hiring a Medicaid Eligibility Specialist who reports directly to the Outreach Supervisor. Conducts presentations throughout the community on New Mexico Medicaid Program. Will meet with groups or individuals. Provide accurate information about the New Mexico Medicaid Program and can assist beneficiaries in enrollment and eligibility assistance for potential and existing New Mexico Medicaid beneficiaries. Processes eligibility applications and determines eligibility for the program. Enters eligibility information into a web-based computer system and references other NM-specific databases as appropriate. Follows up with beneficiaries with correspondence, performs file updates as information comes in, and assesses service/information. Your assistance will make a positive difference in the organization you support. You will be able to provide successful administration and resolve inquiries and deliver positive customer experience while meeting performance goals.

Key Responsibilities:

• Support the research process unit for the SBE (state-based exchange)
• Determine eligibility for NM Medicaid Program according to the NM Medicaid Care regulations/guidelines by reviewing documentation to accurately enter data into a web-based computer system and following procedures for running automated eligibility rules; prepare correspondence for missing information as appropriate; make outbound calls to obtain, clarify, or validate the information.
• Seasoned processor with strong knowledge of all systems used for processing SME (subject matter expert)
• Process applications while maintaining an error rate of 5% or below.
• Assist in the call center when needed.
• Work independently on projects.
• Assist/train new staff when needed.
• Maintain good attendance and punctuality.
• Adhere to changes in policy and procedure.
• Provide clear, complete, accurate, and objective information based on a full understanding of program requirements.
• Build relationships with the community and advocacy groups.

Required Qualifications:

• Must be 18 years of age or older.
• Have a High School Diploma or an equivalent of education required.
• Must be able to submit to pre-employment screening.
• Have legal authorization to work permanently in the United States without requiring a visa transfer or visa sponsorship.
• Have prior clerical/customer service work experience.
• Comfortable working within established processes and procedures.
• Strong communication and customer service skills
• Reliable attendance and strong work ethic

Preferred Qualifications:

• Strong customer service, communication, and problem-solving skills.
• Experience handling escalated customer concerns and complex issues.
• Positive and energetic attitude.
• Ability to communicate clearly and confidently.
• Ability to multi-task and manage time effectively.
• Attestation to detail, grammar, and spelling accuracy.
• Computer system experience with data entry and database documentation knowledge.

What We Offer:

• Pay Rate is $19.00 per hour (Bi-weekly pay), which may be your state's minimum wage. Please take this into consideration when applying.
• Benefits from day one (medical, dental, vision) for eligible roles.
• PerkSpot Employee discount program.
• Paid time off and holidays.
• Paid training.
• Equipment provided.
• Career growth and advancement opportunities.
• Supportive and inclusive work environment.
• No weekend.
• Full time (Mon. Fri. 8:00 AM 4:30 PM)
• Hybrid (WFH 4 days/of the week 1 day in the office)
• Hybrid after training period

Apply now and make an impact from day one

Pay Transparency:

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 $19.00 per hour, which may be below your state's minimum wage. Please take this into consideration when applying.

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 click.appcast.io. You may also click here to access Conduent's ADAAA Accommodation Policy.

Job Identification 25683

Job Category Transaction Processing

Locations 1720 Randolph Rd SE Suite 100, Albuquerque, NM, 87106, US (Hybrid)