Medicaid Eligibility Specialist

Join to apply for the Medicaid Eligibility Specialist role at Davis Behavioral Health, Inc.

The Medicaid Eligibility Specialist is responsible for receiving and working the daily eligibility files from Utah Medicaid, verifying that the DBH Electronic Health Record (EHR) has current and correct information. If the information is incorrect, the specialist updates it in the EHR, contacts the client to explain any issues, determines if assistance is needed, and collaborates with case management staff to help the client restore Medicaid coverage.

The specialist also coordinates with the billing department to ensure accurate accounts. Eligibility is checked monthly for all Fee‑for‑Service and Expansion Medicaid clients.

• Run and work 834 eligibility files.
• Update payer information in DBH’s electronic health record (Credible), as needed.
• Contact clients and explain changes in eligibility.
• Other duties and responsibilities as needed and assigned.

• Contact clients and explain changes in Medicaid eligibility and work with case‑management staff to help clients re‑enroll.
• Work on Medicaid pre‑billing error reports.
• Enter inpatient services for billing Medicaid.
• Other duties and responsibilities as needed and assigned.

This is a full‑time, non‑exempt position (40 hours per week). The proposed schedule is Monday through Friday, 8:00 a.m.–4:30 p.m. with a 30‑minute lunch. The employer reserves the right to require occasional overtime, weekend work, and/or assignments to evening or night shifts.

The finance office is located in the DBH Main Street Clinic at 934 South Main Street, Layton, UT 84041. The environment is a busy office where the employee must meet multiple deadlines and interact with many people. Noise levels may vary depending on daily activities.

Hourly rate: $18.00 per hour. All new employees have a six‑month introductory period during which performance is evaluated.

• At least 18 years old.

• Previous experience working in a professional office setting is required.
• A working knowledge and previous experience with Medicaid enrollment is strongly preferred.

• High school diploma or equivalent is required.

• Complete all required training assigned to the position by defined deadlines.

• Computer literacy, including keyboarding (typing) skills.
• Proficient working knowledge of Microsoft Office Suite and other computer programs.
• Strong verbal and written communication skills.
• Ability to work individually and as part of a team, and with staff in multiple departments.
• Fluency in English and Spanish helpful but not required.

Davis Behavioral Health offers a comprehensive benefits package. Key components include:

• Medical insurance (Select Health Share, High Deductible Health Plan with Health Savings Account).
• Dental insurance (Delta Dental).
• Vision insurance (VSP).
• Integrated primary care (Nice Healthcare).
• Flexible Spending Account (APA Benefits) – $3,300 annual medical limit, $5,000 annual dependent limit.
• Retirement:
  Utah Retirement System, 401(k) with 2% match, voluntary 457 and Roth IRA options.
• Life and AD&D insurance (USAble) – 2× base earnings (max $300,000), spouse $10,000, child $5,000.
• Long‑term disability (USAble).
• Health Reimbursement Account (H.R.A.) – up to $2,600 contributed by DBH.
• Voluntary insurance (Assurity):
  Accident, critical illness, hospital indemnity.
• Identity theft protection (Allstate Benefits).
• Employee assistance program (EAP) – Intermountain Healthcare.

Davis Behavioral Health is an equal‑opportunity employer. All employees must successfully pass a pre‑employment criminal background check and drug screening. DBH will not hire individuals currently using illegal drugs or abusing alcohol. Candidates offered employment are required to report for a drug screen within 24 hours of being requested.

DBH is a drug‑free workplace and complies with federal drug laws, including no use of medical marijuana. All employees must pass a pre‑employment criminal background check as part of the licensing agreement with the State of Utah.