Medicaid Eligibility Case Reviewer

Staffing Solutions Organization LLC

. Manage assigned caseload and complete eligibility determination tasks within State-specified timelines .

Posted 9/15/2026full-timeRemote • New Hampshire • United StatesJunior💰 $23 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing eligibility determinations and applicant documentation in compliance with State and federal Medicaid regulations. Proficient in conducting virtual interviews and providing clear explanations of financial eligibility criteria and documentation requirements.

Highest-signal resume keywords

Medicaid Eligibility ReviewFinancial Eligibility CriteriaQuality Customer Service PrinciplesOrganizational SkillsExcellent Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Eligibility DeterminationCase ManagementDocumentation ReviewDecision TreesQuality Assurance AuditsProblem-SolvingFinancial DocumentationRemote Work CompetencyMedicaid LTC EligibilityNew Hampshire Medicaid Regulations

Soft Skills

Interpersonal SkillsCollaborationIndependenceAttention to Detail

Tools & Technologies

State Case Management SystemsVirtual Interview Platforms

Industry Keywords

Public ProgramsEligibility RequirementsFederal Medicaid RulesNew Hampshire Medicaid

About the role

Key responsibilities & impact

Manage assigned caseload and complete eligibility determination tasks within State-specified timelines
Maintain accurate and timely applicant documentation using State case management and eligibility systems
Review cases for completeness and identify additional documentation or information needed
Schedule and conduct virtual interviews with applicants
Provide education about financial eligibility criteria and required documentation
Use checklists, tools, and decision trees to verify financial eligibility criteria
Develop and submit eligibility recommendations according to State policy and federal Medicaid rules
Process calls and electronic inquiries regarding application status, documentation, timelines, and next steps
Support supervisors in correcting errors identified during quality assurance audits

Requirements

What you’ll need

High school diploma, or equivalent required
Must be 18 years of age or older
1–3 years of experience performing reviews for public programs with eligibility requirements
Experience with Medicaid or Medicaid LTC eligibility preferred
Ability to speak, read, and write English clearly and concisely
Employment is contingent on completion of a background check
Must have a private space with no distractions and reliable, high-speed internet connection
Ability to work independently and collaboratively in a remote team environment
Ability to understand and apply New Hampshire Medicaid long-term care financial eligibility criteria
Ability to explain processes, documentation requirements, and complex eligibility rules
Competency in applying quality customer service principles
Strong organizational, documentation, and problem-solving skills
Excellent communication and interpersonal skills
Familiarity with Federal and New Hampshire Medicaid financial eligibility regulations and processes preferred

Benefits

Comp & perks

Health, vision, and dental insurance
401(k) with discretionary employer match
Paid time off and holidays
Flexible spending accounts
Other perks