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DevCare Solutions · 1 day ago

Eligibility Specialist

United States

Contract

Remote

New Grad, Entry Level

DevCare Solutions is a company focused on providing support for Medicaid recipients. They are seeking an Eligibility Specialist to assist clients with enrollment and eligibility verification for the HIPP/Premium Assistance program, ensuring accurate documentation and timely processing of payments.

ComputerConsumer ElectronicsCRMInformation TechnologyRoboticsSoftware

Responsibilities

Provide enrollment assistance and guidance to Medicaid-eligible recipients and their families regarding the HIPP / Premium Assistance program via phone or correspondence

Verify, document, and investigate existing health coverage for Medicaid recipients and their dependents

Assist in identifying members who may qualify for HIPP / Premium Assistance

Obtain and verify documents required for eligibility: insurance policies, employment verification, premium invoices, etc

Maintain active case files during open enrollment cycles, premium review, and payment processing

Process, review, and follow up on premium payments / reimbursements, ensuring timely and accurate payments, and tracking any discrepancies

Perform ongoing case maintenance and audits, updating records for status changes, renewals, terminations, or escalations

Complete periodic reporting (e.g. case metrics, enrollment trends, audit reports) as required by state or internal stakeholders

Conduct advanced document review, legal research or case escalation as needed, particularly on more complex cases

Prioritize case events, manage deadlines, escalate issues to supervisors or subject matter experts when appropriate

Qualification

Medicaid eligibility knowledgeDocument verificationCase managementLegal researchCommunication skills

Required