Medicaid Eligibility Technician

Position Summary:
This position is responsible for the professional administration of ACA Medicaid Programs for single adults, families, children, and pregnant women. Eligibility determination and case management of multiple programs are accomplished through a series of analysis and evaluations by interpreting and applying the appropriate Federal and State mandated rules and other Medicaid programs

Key Responsibilities:

• Analyze, determine eligibility, and authorize benefits; analyses information to identify potential client eligibility for appropriate programs, evaluates household composition, resources, income and expenses and their effect on eligibility for each client and program, Using knowledge of federal and state laws, rules and regulations, and laws regarding real estate, finances, estates etc., applies different policies or budgeting methodologies to meet client's individual needs and to determine eligibility for programs.
• Request, review, and evaluate supporting documentation necessary to complete eligibility determinations.
• Process Medicaid renewals, redeterminations, and reported changes that may affect continued eligibility.
• Maintain accurate and complete case records, documenting eligibility decisions, verification information, and other actions taken.
• Communicate with applicants regarding application status, eligibility decisions, required documentation, and additional information needed.
• Coordinate with Patient Registration, Alternate Resources, and other departments to address Medicaid coverage and eligibility concerns.
• Daily coordination with the tribal Business Process Specialist.
• View RBHC appointment list pre-appointment and daily to verify patients’ health insurance and use as a to enroll patients in health insurance.
• Document all encounters and work activities and provide monthly reports to supervisor.
• Other duties as assigned. 

Minimum Qualifications:

• High school diploma or equivalent

Preferred Qualifications:

• Associates or Bachelor’s degree in related field

Please note that all communication regarding the recruitment and selection process will be conducted via email.

Disclaimer

This employment announcement does not contain a comprehensive description of the activities, duties, or responsibilities required for this position. Duties, responsibilities, and activities may be reviewed and modified periodically based on organizational needs.

Applicants who do not meet the minimum qualifications established for the position will not be considered. Rocky Boy Health Center prioritizes applicants who demonstrate recent, relevant employment experience. Applicants should have verifiable employment history within the preceding 12 months. Candidates without recent employment history may be screened out of consideration unless their qualifications, education, training, or other relevant experience warrant further review.

Rocky Boy Health Center Human Resources is not responsible for ensuring the completion of application packages. Only applications received in complete and proper form will be considered.

This employment announcement is subject to change based on budget availability and organizational priorities. Employment offers are contingent upon satisfactory completion of a background check and pre-employment drug screening. Successful applicants will be subject to a 60-business-day probationary period.

Notice to Recruiting Agencies and Third-Party Vendors

Rocky Boy Health Center does not accept unsolicited resumes, proposals, or candidate submissions from recruiting agencies or third-party vendors. We are not seeking new recruiting or placement services for any positions at this time. Any unsolicited submissions will be considered the property of Rocky Boy Health Center, and we will not be responsible for any associated fees.