Eligibility Specialist

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Key/Essential Functions & Responsibilities
+ Regularly reviews Medicaid rejections and/or proactively identifies eligibility issues for review and compiles information or makes notifications to facilitate corrective action to support billing and maximize reimbursement for services including submitting documentation or applications to government agencies, alerting Care Coordination Organizations (CCOs) of lapses in coverage and advising of spenddown not being paid/processed.
+ Reviews and responds to requests from government agencies and/or denials of entitlements by obtaining and compiling required documentation from electronic systems, program staff or other sources to establish, maintain or expand benefit entitlements for persons supported in assigned region and/or area(s).
+ Completes forms and applic...