Role Description The Bilingual Medicare/Medicaid Eligibility Specialist advocates and assists low-income Medicaid beneficiaries apply to and requalify for government assistance programs. This role is required to provide exceptional customer service, offer member support, and address questions related to the programs associated with our member screening. This role also requires Spanish speaking and writing proficiency and is a 95% phone-based role. Key Responsibilities - Regularly utilize bilingual (Spanish) skills to communicate with members. - Place and receive calls via a computer interface to conduct telephonic outreach and screening for members who must apply or recertify and are potentially eligible for Medicaid and State Children’s Health Insurance Programs (SCHIP). - Promote company services and gain cooperation from the health plan members or the head of household. - Capture personal/sensitive, financial information to accurately determine eligibility for various government programs. - Utilize the computer system to accurately complete the screening for account eligibility and disposition the account in a timely manner as required. - Compile, record, and evaluate personal and financial data to verify completeness and accuracy. - Interpret and explain information such as eligibility requirements and application details. - Initiate procedures to refer customers/members to other agencies for assistance as appropriate. - Assist members and collaborate with government agencies to accurately complete the benefit application submission and recertification process following eligibility screening. - Secure documentation for Medicaid/SCHIP renewal applications if needed for members. - Attention to detail by adhering to state requirements and securing supporting documentation. - Meet daily, weekly, and monthly production goals while ensuring proper phone etiquette and adherence to scripts, state regulations, HIPAA compliance, and ongoing corporate compliance standards. - Participate as required in operational development programs. - Research changes with any state and federal regulatory requirements to adhere to strict compliance of all aspects of Medicaid and SCHIP Enrollment programs. - Demonstrate behaviors, actions, and attitudes that reflect our vision, mission, and values. - Prepare for and participate in all appropriate meetings. - Perform miscellaneous administrative tasks as required. - Provide peer coaching and support to team members as needed. - Assist with training sessions or onboarding activities when requested by leadership. - Other duties as assigned. Qualifications - Requires Spanish speaking and writing proficiency. - Strong working knowledge of Microsoft Products, Windows, Word, Excel, Outlook, TEAMS /technology focused. - Basic Medicare/Medicaid/Healthcare background. - Basic knowledge of government programs and associated eligibility requirements. - Ability to analyze and interpret governmental program criteria. - Must be able to navigate through multiple databases/monitors. - Familiar with commonly used concepts, practices, and procedures within government health care programs. - Ability to manage high call volume. - Familiar with auto dialing systems. - Strong telephone, analytical, and interpersonal skills. - Strong organizational, problem-solving, decision-making skills. - Strong conflict management. - Excellent customer service/phone voice skills. - Strong time management skills/ability to meet deadlines. - Strong change management skills. - Strong logical reasoning skills and critical thinking skills. - Strong data entry skills. - Ability to manage multiple priorities simultaneously. Education, Certification, and Experience - Required: 2+ years of experience in the related field. - Preferred: Associate degree / equivalent professional experience will be considered in lieu of a degree. Attributes - Strong ability to persuade or influence. - Strong communication skills. - Active listener. - Detail oriented. - Compassionate. - Assertive. - Shows initiative. - Goal/action oriented. - Strong work ethic. Physical Demands - Sitting, Typing, Talking, Hearing/Listening. Security Roles and Responsibilities Centauri’s associates are granted access to information resources to facilitate their responsibilities. All associates must understand and agree to their Information security roles and responsibilities before accessing any of Centauri’s information systems. It is the responsibility of every associate to ensure the safety and confidentiality of data and systems by adhering to the organization’s information security policies and immediately reporting any possible security violations. Benefits - Comprehensive medical, dental, vision, and prescription coverage. - Wellness program supporting overall well-being. - Company-paid basic life and AD&D insurance. - 401(k) plan with company match. - Tuition reimbursement opportunities. - Paid time off for vacation and illness. - Six paid company holidays. - Floating holiday. - Company-paid training and computer equipment. - Performance-based bonus program. - Paid time off for volunteer activities. - Employee referral bonus program. - Career development and training opportunities, including leadership growth.