ELIGIBILITY SUPPORT SPECIALIST
$55,000–$63,000 year
On-siteProspect Place, Florida, United States
Job Summary
Assist PACE participants with completing, processing, and submitting new and renewal Medicaid applications while ensuring accuracy, completeness, and compliance with program requirements. Conduct detailed reviews of applications to confirm readiness, identify errors prior to submission, and track status to resolve outstanding issues. Provide education to participants regarding renewal timelines, required documentation, and program expectations to reduce coverage lapses. Collaborate with Eligibility, Enrollment, IDT, Compliance, Business Development, Shared Services, and Site Directors to coordinate renewal activities and align processes with organizational goals. Maintain accurate records of interactions and generate reports on renewal activity and participant satisfaction to support decision-making.
Required Qualifications
- Associate degree or equivalent business experience of 2 years
- Minimum of two (2+) years in the healthcare industry
- Minimum of one (1+) year of experience working with the older adults
- In-depth knowledge of government programs: Medicare, Medicaid, PACE
- Excellent organizational and communication skills
- Proficient with Microsoft Office software (Word, Excel, PowerPoint, and Outlook)
- Customer Service Orientation: Demonstrates empathy, patience, and professionalism in participant interactions
- Analytical Skills: Reviews applications for accuracy and compliance with program standards
- Collaboration: Works effectively with cross-functional teams to achieve renewal goals
- Organizational Skills: Manages participant caseloads and Medicaid renewal schedules efficiently
- Adaptability: Adjusts to evolving program requirements and organizational priorities
- Problem‐Solving: Identifies issues and develops solutions to improve the renewal process
- Standing – Duration of up to 6 hours a day
- Sitting/Stationary Positions – Sedentary position in duration of up to 6-8 hours a day for consecutive hours/periods
- Lifting/Push/Pull – Up to 50 pounds of equipment, baggage, supplies, and other items used in the scope of the job using OSHA guidelines, etc.
- Bending/Squatting – Have to be able to safely bend or squat to perform the essential functions under the scope of the job
- Stairs/Steps/Walking/Climbing – Must be able to safely maneuver stairs, climb up/down, and walk to access work areas
- Agility/Fine Motor Skills - Must demonstrate agility and fine motor skills to operate and activate equipment, devices, instruments, and tools to complete essential job functions (ie. typing, use of supplies, equipment, etc.)
- Sight/Visual Requirements – Must be able to visually read documentation, papers, orders, signs, etc., and type/write documentation, etc. with accuracy
- Audio Hearing and Motor Skills (Language) Requirements – Must be able to listen attentively and document information from participants, community members, co-workers, clients, providers, etc., and intake information through audio processing with accuracy
- Cognitive Ability – Must be able to demonstrate good decision-making, reasonableness, cognitive ability, rational processing, and analysis to satisfy essential functions of the job
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