Medicaid Eligibility Specialists

Company: All-Pro Placement Service, Inc.
Location: Baltimore
Posted on: May 4, 2025

Job Description:

Daily Job Functions & Responsibilities:

If you want to know about the requirements for this role, read on for all the relevant information.
Provide Medicaid eligibility determination services for MAGI and Non-MAGI population under the direction of MDH, Office of Eligibility Services, Eligibility Determination Division.Receive and process documents received from MAGI and Non-MAGI applicants and recipients of Medicaid. Information received from the MAGI and Non-MAGI population will also be scanned or data-entered, as appropriate.

Use State automated eligibility and enrollment systems, including Maryland Health Connection, E&E, MMIS, EVS, LTSSMaryland, Beacon, SVES, SAVE, as well as internal and web-based databases and document management and retrieval systems and any such successors to those systems in operation during the term of the Contract, to track and verify applicant and recipient eligibility and enrollment.

Review and determine eligibility for all MAGI and Non-MAGI applications, renewals, and interim changes as directed by the Contract Monitor.

Review and correct Certified Turnaround Document (CTAD) errors for all Maryland jurisdictions. CTADs are front-end errors generated when eligibility transactions transmitted to MMIS fail to process.

Request required verifications, including citizenship and identity, as necessary to determine eligibility for MAGI and Non-MAGI Medicaid applications, renewals and interim changes.

Adhere to the productivity standards by task as directed by the Contract Monitor, which will be general processing standards and not system-specific.


Required Qualifications:
Education
Graduated from an accredited high school or possess a high school equivalency certificate.

Experience
A. A minimum of two (2) years of clerical experience applying policies in a medical care, health insurance, or federal or state entitlement program within the past five years.
B. A minimum of two (2) years of experience working in an office or customer service environment accurately reviewing documents and updating data systems.
C. Basic knowledge of computer software, knowledge of Google Suite and Microsoft Suite.
D. College credits from an accredited college or university may be substituted for the required experience at the rate of 30 credit hours for one year of experience.
E. Ability to navigate State data systems.
F. Ability to adapt to learning quickly, adapt to policy modifications and follow directions.

Keywords: All-Pro Placement Service, Inc., Bethesda , Medicaid Eligibility Specialists, Other , Baltimore, Maryland