The Eligibility Specialist will work with and report directly to the Eligibility Specialist Lead. Eligibility Specialists will provide assistance to Colorado residents seeking medical insurance enrollment and eligibility services for all Medicaid programs with an increased focus on Long Term Care services. Eligibility Specialist will review and process applications for assistance on Colorado Benefits Management System (CBMS). Employee will authorize approval, denial or reduction of benefits based on eligibility.
Job duties/daily tasks include but are not limited to- interpreting and explaining the rules and regulations to clients regarding their eligibility rights and responsibilities. Creating, saving and transferring case files. Constant and ongoing collaboration with team members to understand and meet processing guidelines. Monthly and quarterly reporting of productivity/accuracy/quality to satisfy Colorado State requirements. Continued education and training to assist with aquiring a deep-rooted knowledge of Long-Term Care Medicaid rules and regulations.
Education, Experience, Knowledge/Skills, and Abilities:
Education: High school diploma required. Associates degree or additional college courses preferred.
Experience: Preferred minimum of two years experience determining eligibility within CBMS ideally in Long Term Care Medicaid Eligibility. Proven problem-solving skills and attention to detail.
Knowledge/Skills: Proficient working in an office environment and with normal office equipment (i.e. computer, keyboard, mouse, calculator, copier, printer, fax, scanner, telephone). Proven multitasking/organizational skills working in a high-volume environment.
Ability: to provide verbal, written communication and exhibit professionalism with face to face interactions. Ability to effectively communicate with diverse clients.
Physical Requirements include but are not limited to:
Mobility necessary to perform a variety of tasks that involve standing, walking, sitting, stooping, kneeling, bending and twisting, occasionally climbing stairs or using an elevator, possibly reaching chest high and overhead for materials.
Job Type: Full-time
Pay: $40,000.00 - $65,000.00 per year
Benefits:
Schedule:
Work Location: Hybrid remote in Denver, CO 80221