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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Port St Lucie, FL
onsite
Contract / Temporary to Hire
19.00 - 22.00 USD / Hourly
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.
2025-10-01T20:28:54Z

Eligibility Specialist Job in Port St Lucie | Robert Half