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Eligibility Specialist

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Robert Half

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Location:
United States , Port St Lucie

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Category:
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Contract Type:
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Salary:

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Job Description:

We are looking for a detail-oriented Eligibility Specialist to join our team in Port St Lucie, Florida. In this Contract to permanent position, you will play a critical role in managing eligibility documentation and ensuring compliance for children in out-of-home care. This role requires a strong understanding of Medicaid processes, insurance follow-up, and preauthorization procedures.

Job Responsibility:

  • Prepare and compile comprehensive documentation to facilitate Title IV-E determinations for children entering out-of-home care
  • Enroll newly eligible Medicaid recipients into the Sunshine Child Welfare Specialty Plan
  • Identify and refer children potentially eligible for Social Security benefits to the Master Trust Specialist
  • Process and submit applications for all children under the supervision of CCKids
  • Monitor and manage Title IV-E determinations to prevent expiration and ensure timely re-determinations
  • Review, approve, and organize pre-adoption files submitted by Adoption Case Managers
  • Handle agreements, update placements and services, and coordinate with case managers on adoption case assignments and finalizations
  • Process new Title IV-E applications for children placed in adoption settings promptly and accurately
  • Assist case management teams in obtaining eligibility documentation for adoption cases or future eligibility reviews
  • Address inquiries about Medicaid billing, primary care physician changes, and related matters from foster parents, caregivers, case managers, and investigators

Requirements:

  • Proven experience in Medicaid eligibility and insurance follow-up processes
  • Familiarity with preauthorization procedures and Medicaid billing systems
  • Proficiency in Microsoft Excel for documentation and record-keeping
  • Strong organizational skills and attention to detail
  • Ability to manage multiple tasks and prioritize effectively
  • Excellent communication skills for interacting with caregivers, case managers, and other stakeholders
  • Knowledge of Title IV-E determinations and child welfare systems
  • Experience in handling adoption-related documentation and processes
What we offer:
  • medical, vision, dental, and life and disability insurance
  • eligible to enroll in our company 401(k) plan
  • free online training

Additional Information:

Job Posted:
March 12, 2026

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