Eligibility Specialist II; Non-MAGI

Eligibility Specialist II (Non-MAGI)

Location:

Localized Eligibility Processing (LEP), Anderson County. This in-office role.

This position determines and re-determines Medicaid eligibility according to Medicaid policies and procedures, collects and evaluates documentation from applicants, and completes eligibility determinations, reviews, and changes in an accurate and timely manner.

• Uses various information sources, electronic tools, and systems provided by the Department to collect, assemble, evaluate, and act upon information from applicants and third parties to make timely eligibility determinations, reviews, and changes.
• Demonstrates proficiency in utilizing all processes, policies, procedures, and system updates to ensure accurate determinations, and resolves discrepancies and escalates as appropriate.
• Maintains a professional demeanor and communicates with co‑workers, supervisors, and beneficiaries in a clear, polite, and concise manner, following privacy and confidentiality training.
• Attends mandatory meetings, trainings, and events, complies with all agency policies, and performs other duties as assigned.

A high school diploma and experience in customer service, social services, human services, and/or Medicaid processing. A bachelor's degree may substitute for the required program experience.

• Proficiency with computers, Microsoft Office, internet browsers, and ability to read, write, and speak English clearly.
• Ability to perform basic mathematical computations.
• Experience providing excellent customer service face‑to‑face, telephonically, or written.
• Knowledge of federal rules and standards for Medicaid eligibility determinations.
• Organizational skills to maintain productive work spaces and ensure accuracy and timeliness of determinations.

• Availability for overtime and/or weekend work with deputy approval.
• Ability to sit or stand for long periods.
• Lifting up to 20 lbs.
• Occasional overnight travel.
• In‑office role.

• 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 (including pregnancy, childbirth or related medical conditions, including, but not limited to lactation), national origin, age (40 or older), disability or genetic information.