Medicaid Eligibility Specialist

Medicaid Eligibility Specialist

Location: Des Moine, IA

Company: Creative Senior PlanningDivision: Enrollment Support SolutionsEmployment Type: Full-TimeReports To: Executive Director of Operations

Our Mission

At Creative Senior Planning, we believe every senior deserves access to the care they need without unnecessary financial barriers.

Helping Families. Empowering Providers. Transforming Medicaid Eligibility.

This isn't just our tagline—it's the standard we hold ourselves to every day.

Through compassionate service, operational excellence, and innovative technology, we simplify one of healthcare's most complex processes. We help residents receive Medicaid benefits faster while helping healthcare providers improve financial stability and focus on delivering exceptional care.

Every application represents a family navigating one of life's most difficult transitions. Every relationship strengthens the providers we serve. Every process we improve transforms how Medicaid eligibility is delivered across the country.

As we continue expanding nationally, we're looking for people who share our commitment to service, accountability, innovation, and continuous improvement.

About the Role

The Eligibility Specialist is the operational backbone of our Medicaid Enrollment team.

This is more than processing paperwork.

You'll manage Medicaid eligibility cases from referral through approval, working directly with families, long-term care facilities, state agencies, and internal teammates to ensure every application is completed accurately, efficiently, and with exceptional customer service.

Your work directly impacts residents receiving benefits sooner while helping providers reduce outstanding receivables and improve operational performance.

If you enjoy solving problems, managing complex workflows, staying organized, and making a meaningful difference in people's lives, you'll thrive in this role.

What You'll DoOwn the Medicaid Enrollment Process

• Manage assigned Medicaid applications from referral through approval
• Determine documentation requirements based on resident eligibility
• Collect, verify, and organize financial and eligibility documentation
• Complete and submit accurate Medicaid applications using company systems
• Monitor application status and proactively resolve delays
• Ensure timely follow-up until final eligibility determination

Support Families and Healthcare Providers

• Serve as a trusted resource for residents and family members
• Communicate professionally with nursing facility staff
• Coordinate with state Medicaid agencies and Department of Human Services representatives
• Partner closely with Medicaid Planning Advisors and internal teams
• Provide timely updates throughout the application process
• Deliver compassionate, professional service during challenging life transitions

Maintain Operational Excellence

• Maintain complete and accurate electronic case files
• Document all activity within CRM and internal platforms
• Ensure HIPAA compliance and data confidentiality
• Track deadlines, recertifications, renewals, and required follow-up
• Maintain outstanding documentation quality
• Ensure compliance with all applicable Medicaid regulations and company standards

Help Build Better Systems

As a growing national organization, we expect every employee to contribute to continuous improvement.

You'll help us:

• Improve workflows and efficiencies
• Recommend process improvements
• Support automation initiatives
• Develop best practices for future state expansion
• Help build scalable operational systems that support company growth

Success in This Role

Our top Eligibility Specialists are known for their accuracy, accountability, and ownership.

They consistently:

• Deliver highly accurate Medicaid applications
• Meet or exceed turnaround time expectations
• Maintain exceptional organization across multiple active cases
• Communicate proactively with families and providers
• Resolve issues before they become delays
• Take ownership of every case from beginning to end
• Look for opportunities to improve processes
• Represent Creative Senior Planning with professionalism and compassion

Key Performance Indicators

Performance is measured using objective operational metrics, including:

• Application Accuracy Rate
• Medicaid Approval Rate
• Average Days from Referral to Submission
• Average Days to Approval
• Cases Managed Per Month
• Recertification Completion Rate
• CRM & Documentation Accuracy Score
• Service Level Agreement (SLA) Compliance
• Family Satisfaction Score
• Facility Satisfaction Score
• Escalation Resolution Time
• Internal Quality Audit Score

QualificationsRequired

• Exceptional organizational and time management skills
• Strong attention to detail
• Excellent written and verbal communication
• Ability to manage multiple priorities simultaneously
• Strong follow-up and problem-solving abilities
• Customer-focused mindset
• Ability to work independently in a remote environment
• Proficiency with Google Workspace or Microsoft Office

Preferred

• Experience with Medicaid eligibility or applications
• Healthcare administration or case management experience
• Long-term care or senior living experience
• Experience using CRM platforms (HubSpot preferred)
• Knowledge of Medicaid regulations and eligibility requirements

The Person Who Will Thrive Here

You're someone who:

• Takes ownership without waiting to be asked
• Loves creating order from complexity
• Notices details others overlook
• Follows through relentlessly
• Solves problems with urgency and professionalism
• Communicates with empathy and confidence
• Values accountability and continuous improvement
• Wants to build something meaningful rather than simply perform a job

Why Creative Senior Planning?

Creative Senior Planning is redefining how long-term care providers manage Medicaid eligibility and resident financial services.

Through innovative technology, operational excellence, and exceptional customer service, we're building scalable solutions that improve outcomes for residents, healthcare providers, and partners across the country.

We're still growing—which means every employee has the opportunity to influence our culture, improve our processes, and grow their career alongside the organization.

If you're looking for more than just a job—if you want to help build a company that is transforming an industry while making a real difference in people's lives—we'd love to meet you.

Creative Senior Planning

Helping Families. Empowering Providers. Transforming Medicaid Eligibility.

Pay: $30.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person

Salary : $30