This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

Benefit & Eligibility Specialists (BESs) are responsible for making financial eligibility determinations for Medicaid programs. BESs provide customer service to diverse populations in a variety of settings that may include in person, phone, and/or call center.

• Completing financial eligibility determinations for ALTCS, SSI MAO, Medicare Savings, KidsCare, Specialty Medicaid and the FTW programs following productivity, timeliness, and quality guidelines.
• Scheduling and conducting interviews.
• Communicating with customers after the interview to include requesting information, status updates and final decision.
• Requesting eligibility verification from multiple sources and reviewing documentation in various systems.
• Researching, following, and applying prescribed policies and procedures.
• Documenting throughout the application process as needed, actions taken, relevant case information, and eligibility related material in case records until final case determination is made using HEAplus system.
• Participating in team meetings, AMS Process improvement, and assisting with special projects.

Qualifications

• Must have a high school diploma or General Equivalency Diploma (G.E.D.) and 6 months customer service related work experience.
• Must successfully pass a test appropriate to area of assignment.
• Chinle office only: Bilingual (fluent) in Navajo.

Requirements

• 1 year customer service related work experience preferred.
• Bilingual (Spanish) a plus but not required.
• Successfully pass fingerprint background check, prior employment verifications and reference checks; employment is contingent upon completion of the above-mentioned process and the agency’s ability to reasonably accommodate any restrictions.
• Driver’s License Requirements if driving is an essential function of the job.
• All newly hired State employees must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).

Benefits

• 10 paid holidays per year
• Paid Vacation and Sick time off (13 and 12 days per year respectively) - start earning it your 1st day (prorated for part-time employees)
• Paid Parental Leave - Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child (pilot program).
• Other Leaves - Bereavement, civic duty, and military.
• A top-ranked retirement program with lifetime pension benefits
• A robust and affordable insurance plan, including medical, dental, life, and disability insurance
• Participation eligibility in the Public Service Loan Forgiveness Program (must meet qualifications)
• RideShare and Public Transit Subsidy
• A variety of learning and career development opportunities