Eligibility Specialist

Job Description

Job Description

POSITION: Eligibility Specialist

McGregor PACE (Program of All-Inclusive Care for the Elderly) is a community-based service program that helps older adults remain safely in their homes by providing comprehensive healthcare and supportive services as an alternative to nursing home placement. At McGregor PACE, our mission is to support seniors with compassionate, high-quality care that promotes independence and quality of life.

POSITION DETAILS

Position Type: Hybrid (in-office days located in Cleveland Heights, Ohio)
Salary Range: $20-$24 per hour, based on experience

Reports to: Eligibility Supervisor

ESSENTIAL DUTIES

• Obtain authorizations and paperwork for Medicaid renewals.
• Respond to participant questions about Medicaid status and benefits.
• Ensure active enrollment status in the McGregor PACE Medicare plan.
• Follow up on application and renewal processes.
• Communicate with the Eligibility Manager and/or Team Lead about any delays affecting eligibility.
• Keep accurate and detailed notes on correspondence with participants and Medicare/Medicaid agencies.
• Utilize both internal and external software systems as required.
• Prepare and communicate the participant's share of cost to group home and assisted living facilities.
• Complete other duties as assigned.

QUALIFICATIONS

• One year of experience in Medicaid waiver programs and health or social services preferred.
• Experience working with older adults, especially those with dementia, preferred.

• Knowledge of Ohio Medicaid and Federal Medicare regulations and systems preferred.
• Current Ohio driver’s license and reliable transportation required.
• Proficiency in Windows, Word, Excel, and PowerPoint required.
• Strong communication skills required.