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Eligibility Specialist

United States, Port Saint Lucie · Job Posted June 15, 2026
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Job Responsibility

  • Gather and organize records needed to complete Title IV-E eligibility reviews for children entering out-of-home care at the time of removal
  • Submit Medicaid applications for children placed in care and ensure each request is filed within required turnaround times
  • Enroll newly eligible children in the appropriate child welfare specialty Medicaid plan and confirm coverage setup is completed correctly
  • Identify cases that may qualify for Social Security-related benefits and route them to the appropriate trust or benefits specialist for follow-up
  • Prepare and process eligibility applications and redeterminations for children under supervision, maintaining active coverage without lapses
  • Review adoption-related eligibility files for completeness, maintain documentation, and coordinate with adoption case managers on approvals and finalization steps
  • Process adoption Title IV-E requests, update placement and service records, and manage related agreements as needed
  • Respond to questions from foster parents, caregivers, investigators, and case managers regarding Medicaid billing issues and primary care provider changes
  • Complete required system updates so the appropriate payee information is reflected accurately within designated Medicaid-related platforms

Requirements

  • Experience working with Medicaid eligibility, insurance follow-up, or related healthcare benefits processes
  • Knowledge of documentation standards and timelines associated with public assistance or child welfare eligibility programs
  • Ability to manage multiple cases while maintaining strong attention to detail and accuracy
  • Proficiency in Microsoft Excel and general computer-based case or records management systems
  • Strong written and verbal communication skills for working with case managers, caregivers, and internal support teams
  • Ability to handle sensitive information with professionalism and confidentiality

Nice to have

Familiarity with preauthorization or insurance-related coordination

What we offer

  • Medical
  • vision
  • dental
  • life and disability insurance
  • 401(k) plan
  • free online training

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