MEDICAID ELIGIBILITY SPECIALIST
Core
Review and process Medicaid eligibility applications, renewals, and changes for long-term care programs, determining eligibility based on NYC, NYS, and Federal guidelines.
Role type
Medicaid Eligibility Specialist
Builds
Eligibility decisions for Home Care Services Program consumers
Domain
Public sector social services / Medicaid administration
Required skills
Document review, Eligibility determination, System data entry, Case management, Guideline application, Notice generation
Responsibilities
Review Medicaid applications and renewals for completeness; Complete case actions in Welfare Management System (WMS) and external applications; Determine need for additional documentation or referrals; Consult with supervisors on complicated cases.