Note: The job is a remote job and is open to candidates in USA. Blue Cross & Blue Shield of Rhode Island is a healthcare organization dedicated to serving Rhode Islanders. The Temporary Medicaid Specialist coordinates Medicaid application and redetermination activities to help members and prospective members obtain or maintain eligibility and support enrollment and retention in the DSNP program.
Responsibilities
- Conduct eligibility assessment of prospective members for Medicaid enrollment
- Communicate Medicaid rules and regulations to members and prospective members
- Serve as a liaison between prospective members and EOHHS (Medicaid)
- Assist existing members with Medicaid redetermination process by verifying members’ eligibility and by assisting with identification of necessary supporting documentation
- Initiate and maintain proper follow-up with the member/prospective member and EOHHS caseworkers to ensure timely processing and completion of all mandated applications and accompanying documentation
- Maintain a log of Medicaid eligibility and complete all re-determinations for members
- Document progress notes to member/prospect file in SFDC
- Participate in ongoing, comprehensive training programs as required
- On occasion, perform home visits to complete all Medicaid applications on all new enrollees and re-determinations within a reasonable time frame
- Perform other duties as assigned
Skills
- High school diploma or GED
- Up to two years of previous professional experience in a related position
- Excellent interpersonal skills, ability to negotiate with customers and remain diplomatic
- Working knowledge of Medicaid eligibility requirements, computer programs and software
- Ability to communicate and present information to various levels of personnel
- Computer navigation skills
- Written and verbal communications skills
- Time management skills
- Ability to collect and organize data
- Ability to work independently
- Ability to meet established time and quality standards
- Ability to exercise sound judgment
Benefits
- Flexible work arrangements, including remote and hybrid opportunities
- Paid time off
- Tuition reimbursement
- Student-loan repayment assistance
- Health, dental, and vision insurance
- Programs that support mental health and well-being
- Bonuses
- Investment plans
- Commitment to growing and developing employees
- Additional paid time to volunteer
- Ongoing, comprehensive training programs as required
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