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Eligibility Specialist
Eligibility SpecialistRobert Half • Port Saint Lucie, FL, US
Eligibility Specialist

Eligibility Specialist

Robert Half • Port Saint Lucie, FL, US
18 days ago
Job type
  • Full-time
Job description

Job Description

Job Description

We are looking for a detail-oriented Eligibility Specialist to join our team in Port St Lucie, Florida. In this role, you will play a critical part in ensuring the accurate and timely processing of Medicaid applications, Title IV-E determinations, and other related documentation for children in out-of-home care. This position requires strong organizational skills and the ability to collaborate effectively with various stakeholders to address eligibility and insurance-related matters.

Responsibilities :

  • Compile and review documentation to complete Title IV-E determinations for children entering out-of-home care.
  • Enroll new Medicaid recipients in the Sunshine Child Welfare Specialty Plan.
  • Refer eligible children to the Master Trust Specialist for potential Social Security benefits.
  • Submit and manage Medicaid applications for children under supervision, ensuring timely processing within 48 business hours of removal.
  • Monitor and ensure Title IV-E determinations remain current, completing re-determinations as needed.
  • Organize, approve, and maintain pre-adoption files in collaboration with Adoption Case Managers.
  • Process adoption agreements, update placements and services, and coordinate with case managers on finalizations.
  • Address Medicaid billing inquiries and assist caregivers, case managers, and investigators with eligibility documentation.
  • Manage new Adoption Title IV-E applications and ensure their accuracy and timely submission.
  • Interface with internal systems to designate the organization as the Medicaid Payee when applicable.
  • Proven experience with insurance follow-up, Medicaid eligibility, or related processes.
  • Familiarity with preauthorization procedures and Medicaid application workflows.
  • Proficiency in using Microsoft Excel for data organization and reporting.
  • Strong understanding of Medicaid guidelines and requirements.
  • Excellent organizational skills with the ability to manage multiple priorities effectively.
  • Strong communication and interpersonal skills to work with diverse stakeholders.
  • Detail-oriented mindset to ensure accuracy in documentation and determinations.
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Eligibility Specialist • Port Saint Lucie, FL, US