Eligibility Specialist II; MAGI​/TG

* This is a Temporary Grant position.*

The Agency's mission is to be boldly innovative in improving the health and quality of life for South Caro linians.

This position is located in Eligibility, Enrollment and Member Service (EEMS) Processing Centers, Spartanburg County.

This is an in-office role and not a telecommute or remote position.

Determine/re-determine Medicaid eligibility according to Medicaid policies and procedures. Collect and evaluate documentation from applicants to determine individual and family eligibility, complete all assigned eligibility determinations, reviews, and changes accurately and in a timely manner.

• Use various information sources, electronic tools, and systems to collect, assemble, evaluate, and act upon information from applicants, beneficiaries, and third parties for timely eligibility determinations, reviews, and changes of circumstance. Follow policies for collection and analysis of applications, gather additional information with minimal burden, perform follow‑up efficiently and effectively, and document all notes and steps clearly for hand‑off to other specialists.
• Demonstrate proficiency in all processes, policies, procedures, and system updates to ensure accurate and satisfactorily documented eligibility determinations. Make accurate determinations based on departmental rules and standards, resolve discrepancies in a timely manner, follow escalation processes, and keep all documentation, records, and notes clear and accurate.
• Maintain a professional demeanor and communication style, ensuring that interactions with co‑workers, supervisors, and beneficiaries are clear, polite, and concise. Participate in customer service and privacy training and keep confidential information protected per state and federal law.
• Attend all mandatory meetings, trainings, and events as directed, comply with all agency policies—including privacy, confidentiality, performance, leave and compensation, vehicle use and travel, financial controls—and stay certified for emergency management duties when required. Perform other duties as assigned.

• Overtime and/or weekend work with Deputy approval.
• Sitting or standing for long periods of time.
• Lifting requirements: up to 20 lbs.
• In‑office role (no telecommute).
• Familiarity with computers, standard Microsoft Office software, internet browsers, and ability to read, write, and speak English clearly and concisely.
• Ability to perform basic mathematical computations.
• Ability to work in a professional office environment with a diverse group of teammates and provide excellent customer service face‑to‑face, telephonically or via written communication.
• Ability to learn, retain, and apply federal rules and standards for Medicaid eligibility determinations.
• Ability to maintain productive work spaces and perform tasks effectively to ensure completeness, accuracy, and timeliness of determinations.

• Health, Dental, Vision, Long‑Term Disability, and Life Insurance for employee, spouse, and children.
• 15 days annual (vacation) leave per year.
• 15 days sick leave per year.
• 13 paid holidays.
• State Retirement Plan and Deferred Compensation Programs.

The South Carolina Department of Health and Human Services is committed to providing equal employment opportunities to all applicants and does not discriminate on the basis of race, color, religion, sex, national origin, age (40 or older), disability or genetic information.