Medicaid Eligibility Specialist

Service Center Representative - Eligibility Specialist

The Service Center Representative - Eligibility Specialist is responsible for receiving high-volume, often back-to-back, inbound calls about Medicaid, Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) programs. The Eligibility Specialist will assist customers by answering queries, handling complaints, and troubleshooting problems in a professional manner ensuring effective resolution and customer satisfaction.

Training: 9-10 Weeks with NO TIME OFF DURING TRAINING

Required Education: HS Diploma or equivalent

Required Qualifications:

• Proven Customer Support or Client Service Representative Experience
• 2 years relevant professional experience or 1-year relevant experience and 1 year of extended education and the ability to handle complex service inquiries via telephone
• Accurate data entry (40 WPM or 10,000 KSPH)
• Ability to handle complex service inquiries via telephone
• Strong PC skills

Preferred Qualifications:

• Social services experience (Indiana Eligibility experience strongly preferred)

Soft Skills Required:

• Strong critical thinking and problem-solving skills
• Strong interpersonal skills
• Positive relationship-building with customers and state eligibility consultants
• Attention to detail; excellent organizational, verbal, and written communication skills
• Capable of executing many complex tasks simultaneously
• Team player with the ability to work independently
• Comfortable in a fast-paced, deadline-oriented environment

Work Environment:

Work is constantly performed in an office environment. Ability to remain stationary for an extended period. Moderate difficulty assignments requiring judgment and issue resolution. Qualified candidates are provided an extensive training program to be successful in this role.

During calls, an Eligibility Specialist is expected to process applications and complete case maintenance activities such as changes to cases in the State eligibility system. Additionally, an Eligibility Specialist should ensure all client service issues are resolved in a timely manner and in accordance with stated policies and procedures.

Taking inbound calls from Medicaid, SNAP, and TANF applicants, recipients, and other members of the community. Handling high volume of inbound calls daily, which are often back-to-back, during the scheduled work shift to answer questions regarding the Medicaid, SNAP, and TANF programs. Apply State and/or federal eligibility rules for applicant/recipient information assessment. Verifying applicant/recipient data through system interfaces. Facilitating the fulfilment of caller requests regarding eligibility information via a One Call Resolution approach while maintaining professionalism and empathy. Communicating with applicants/recipients while researching and updating cases and documenting calls simultaneously. Educating callers on program services and eligibility requirements while demonstrating excellent communication and customer service skills. Serving as a liaison with customers regularly to meet program goals and maintain program services and eligibility, fostering positive working relationships. Verify and entering applicant/recipient data into the State's eligibility system and prepares cases for disposition by State Eligibility Consultant. Processing cases and takes necessary action on missing information promptly. Meeting Quality Assurance and performance metrics and stay updated on project and corporate policies. Identify and escalating risks to management. Attending all meetings and completes all trainings to stay informed on project/position updates. Fulfilling all performance requirements associated with eligibility processes. Performing additional duties as assigned by management.

**Only those lawfully authorized to work in the designated country associated with the position will be considered.**

**Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client's business needs and requirements.**