Eligibility Specialist I- Medicaid
Mecklenburg County, Raleigh, NC, United States
Hiring Range
$20.00 - $23.07 per hour. Pay rates are based on education, skill, experience level and internal equity. Internal equity considerations include an assessment of the applicant’s salary history and qualifications in comparison to the market rate and requirements for the job.
Position Summary
Under direct supervision, this position performs customer service activities and determines initial and ongoing eligibility for the Medicaid program. The program administered by the Department of Community Resources provides access to essential healthcare services for eligible low‑income families, children, pregnant women, seniors, caretakers, individuals with disabilities, and those requiring long‑term care. This role helps families through the application process, determines eligibility, and connects them with necessary health and social services.
Work Location
The Catherine M. Wilson Center at 301 Billingsley Rd, Charlotte NC 28211. Primary work schedule: Monday – Friday, 8:00 am to 5:00 pm (in‑office; telework not available).
Pre‑Employment Assessment
Candidates selected for an interview will be required to complete an in‑person pre‑employment assessment. The assessment will be a paper‑and‑pencil test administered on a Saturday. Candidates who achieve a score of 80% or higher will move forward in the hiring process.
Training Standards Notice
This position requires that you undergo a structured training program in which performance expectations must be met. By accepting this position, you acknowledge that there are two primary phases of performance measurement that must be met. Phase One is an open book, open note, exam that must receive a passing score of at least 84%. You will be allowed one re‑test if this expectation is not met initially. Phase Two is that you must continuously meet the reasonable minimum quality and training mentoring expectations set and measured on a bi‑weekly cadence. An employee who does not successfully pass either Phase 1 or Phase 2 of the performance‑based training and assessment program may be dismissed from their employment.
Essential Functions
Assist call center or walk‑in contacts, interview customers, gather information, and input data into appropriate systems
Verify customer’s information through paper documentation, online search and phone calls and determine program eligibility
Process applications for single program basic benefits
Respond to client and public inquiries regarding services available, documentation requirements, other community resource options, and ongoing program and benefit status and customer record changes
Perform data entry and maintain system files and databases on clients, providers, and program services
Maintain basic knowledge of multiple social services programs or in‑depth knowledge in one program
Perform work in a high volume, fast‑paced environment with continual customer interaction
Some positions may be required to directly work on enrollment and eligibility activities within the NC FAST system
May be required to staff shelters in the event of a disaster
Experience and Minimum Qualifications
Minimum of two years of experience in customer service with direct interaction with members of the public or successful completion of the CPCC Caseworker Training Program (or another participating program).
Education
High School Diploma or equivalent. Combination of relevant education and experience is accepted.
Licenses and Certifications
A valid North Carolina or South Carolina Driver’s License may be required.
Preferred Qualifications
Associate’s degree preferred
Experience processing insurance claims, mortgage/loan processing, working with specialized computer programs and working in a call center preferred
Bilingual (Spanish and English) proficiency oral and written
Knowledge
Knowledge of principles and processes for providing customer and personal services, including customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
Modern office practices, procedures, and equipment.
Familiar with social service programs.
Skills
Active Listening: Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate.
Service Orientation: Actively looking for ways to help people.
Being aware of others’ reactions and understanding why they react as they do.
Talking to others to convey information effectively.
Communicating effectively in writing as appropriate for the needs of the audience.
Abilities
Communication: Clearly conveying information and ideas through a variety of media to individuals or groups in a manner that engages the audience and helps them understand and retain the information provided.
Continuous Learning / Applied Learning: Actively identifying new areas for learning; regularly creating and taking advantage of learning opportunities; using newly gained knowledge and skill on the job and learning through their application.
Contributing to Team Success / Collaboration: Actively participating as a member of a team to move the team toward the completion of goals; working effectively and cooperatively with others; establishing and maintaining good working relationships.
Customer Focus: Ensuring that the customer perspective is a driving force behind business decisions and activities; crafting and implementing service practices that meet customers’ and own organization’s needs.
Energy / Inspiring Others: Using interpersonal styles and methods to inspire and guide individuals toward higher levels of performance.
Ethical Decision Making: Identifying and understanding issues, problems, and opportunities comparing data from different sources to draw conclusions, using effective approaches for choosing a course of action or developing appropriate solutions; taking action that is consistent with available facts, constraints, and probable consequences.
Managing Work: Effectively managing one’s time and resources to ensure that work is completed efficiently.
Motivation Fit: The extent to which activities and responsibilities available in the job and the organization’s mode of operation and values provide personal satisfaction.
Computer Skills
Proficient in various computer applications including Microsoft Office Suite.
Work Environment
Works in an office setting with moderate noise.
Reasonable Accommodations Statement
To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.
Disclaimer Statement
This is not intended to be an all‑inclusive list of job‑related responsibilities, duties, skills, requirements, or working conditions. Other duties may be assigned based on business need and the supervisor’s request. Mecklenburg County reserves the right to revise the job description at any time. Designated positions may be required to assist in emergency and/or disaster situations.
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$20.00 - $23.07 per hour. Pay rates are based on education, skill, experience level and internal equity. Internal equity considerations include an assessment of the applicant’s salary history and qualifications in comparison to the market rate and requirements for the job.
Position Summary
Under direct supervision, this position performs customer service activities and determines initial and ongoing eligibility for the Medicaid program. The program administered by the Department of Community Resources provides access to essential healthcare services for eligible low‑income families, children, pregnant women, seniors, caretakers, individuals with disabilities, and those requiring long‑term care. This role helps families through the application process, determines eligibility, and connects them with necessary health and social services.
Work Location
The Catherine M. Wilson Center at 301 Billingsley Rd, Charlotte NC 28211. Primary work schedule: Monday – Friday, 8:00 am to 5:00 pm (in‑office; telework not available).
Pre‑Employment Assessment
Candidates selected for an interview will be required to complete an in‑person pre‑employment assessment. The assessment will be a paper‑and‑pencil test administered on a Saturday. Candidates who achieve a score of 80% or higher will move forward in the hiring process.
Training Standards Notice
This position requires that you undergo a structured training program in which performance expectations must be met. By accepting this position, you acknowledge that there are two primary phases of performance measurement that must be met. Phase One is an open book, open note, exam that must receive a passing score of at least 84%. You will be allowed one re‑test if this expectation is not met initially. Phase Two is that you must continuously meet the reasonable minimum quality and training mentoring expectations set and measured on a bi‑weekly cadence. An employee who does not successfully pass either Phase 1 or Phase 2 of the performance‑based training and assessment program may be dismissed from their employment.
Essential Functions
Assist call center or walk‑in contacts, interview customers, gather information, and input data into appropriate systems
Verify customer’s information through paper documentation, online search and phone calls and determine program eligibility
Process applications for single program basic benefits
Respond to client and public inquiries regarding services available, documentation requirements, other community resource options, and ongoing program and benefit status and customer record changes
Perform data entry and maintain system files and databases on clients, providers, and program services
Maintain basic knowledge of multiple social services programs or in‑depth knowledge in one program
Perform work in a high volume, fast‑paced environment with continual customer interaction
Some positions may be required to directly work on enrollment and eligibility activities within the NC FAST system
May be required to staff shelters in the event of a disaster
Experience and Minimum Qualifications
Minimum of two years of experience in customer service with direct interaction with members of the public or successful completion of the CPCC Caseworker Training Program (or another participating program).
Education
High School Diploma or equivalent. Combination of relevant education and experience is accepted.
Licenses and Certifications
A valid North Carolina or South Carolina Driver’s License may be required.
Preferred Qualifications
Associate’s degree preferred
Experience processing insurance claims, mortgage/loan processing, working with specialized computer programs and working in a call center preferred
Bilingual (Spanish and English) proficiency oral and written
Knowledge
Knowledge of principles and processes for providing customer and personal services, including customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
Modern office practices, procedures, and equipment.
Familiar with social service programs.
Skills
Active Listening: Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate.
Service Orientation: Actively looking for ways to help people.
Being aware of others’ reactions and understanding why they react as they do.
Talking to others to convey information effectively.
Communicating effectively in writing as appropriate for the needs of the audience.
Abilities
Communication: Clearly conveying information and ideas through a variety of media to individuals or groups in a manner that engages the audience and helps them understand and retain the information provided.
Continuous Learning / Applied Learning: Actively identifying new areas for learning; regularly creating and taking advantage of learning opportunities; using newly gained knowledge and skill on the job and learning through their application.
Contributing to Team Success / Collaboration: Actively participating as a member of a team to move the team toward the completion of goals; working effectively and cooperatively with others; establishing and maintaining good working relationships.
Customer Focus: Ensuring that the customer perspective is a driving force behind business decisions and activities; crafting and implementing service practices that meet customers’ and own organization’s needs.
Energy / Inspiring Others: Using interpersonal styles and methods to inspire and guide individuals toward higher levels of performance.
Ethical Decision Making: Identifying and understanding issues, problems, and opportunities comparing data from different sources to draw conclusions, using effective approaches for choosing a course of action or developing appropriate solutions; taking action that is consistent with available facts, constraints, and probable consequences.
Managing Work: Effectively managing one’s time and resources to ensure that work is completed efficiently.
Motivation Fit: The extent to which activities and responsibilities available in the job and the organization’s mode of operation and values provide personal satisfaction.
Computer Skills
Proficient in various computer applications including Microsoft Office Suite.
Work Environment
Works in an office setting with moderate noise.
Reasonable Accommodations Statement
To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodations may be made to help enable qualified individuals with disabilities to perform the essential functions.
Disclaimer Statement
This is not intended to be an all‑inclusive list of job‑related responsibilities, duties, skills, requirements, or working conditions. Other duties may be assigned based on business need and the supervisor’s request. Mecklenburg County reserves the right to revise the job description at any time. Designated positions may be required to assist in emergency and/or disaster situations.
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