About the Role
Our client is seeking Claims Processor to join their team and assist with processing Medicaid applications. This role involves collecting and evaluating documentation from applicants to determine individual and family eligibility for the program. Specialists will ensure all determinations, reviews, and changes are completed accurately and on time.
Key Responsibilities
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Review and process Medicaid applications using departmental systems and tools.
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Collect, assemble, and evaluate applicant information to make eligibility determinations.
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Follow established policies and procedures for documentation and verification.
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Perform follow-up activities efficiently to obtain outstanding information.
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Document all steps and notes clearly for review and hand-off.
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Resolve discrepancies and escalate issues as needed.
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Maintain professionalism and clear communication with applicants, team members, and supervisors.
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Ensure compliance with privacy and confidentiality standards under State and Federal law.
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Attend mandatory meetings, trainings, and maintain certifications as required.
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Perform other duties as assigned by supervisory staff.
Minimum Requirements
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High school diploma and relevant experience in customer service, social services, human services, or Medicaid processing.
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A bachelor’s degree may substitute for required experience.
Preferred Qualifications
- Proficiency with computers, Microsoft Office, and internet browsers.
- Strong communication skills in English (written and verbal).
- Ability to perform basic mathematical computations.
- Excellent customer service skills in person, by phone, and in writing.
- Ability to learn and apply federal rules and standards for Medicaid eligibility.
- Strong organizational skills and attention to detail.
Schedule: Monday–Friday, 8:30 AM – 5:00 PM (7.5 hours daily)
Start Date: January 13
Pay Rate: $15/hour
Benefits: FGP offers contract employees benefits including minimum essential coverage insurance, a fixed indemnity plan and a 401k retirement plan once eligibility requirements are met.
