Medicare Eligibility Specialist

At WelbeHealth, we’re transforming the reality of senior care by providing an all-inclusive healthcare option to our most vulnerable senior population, functioning as both a care provider and care plan to those we serve.

Our Health Plan Services team plays a critical role in our participants’ journeys, and our Eligibility & Reconciliation team helps support both our prospective and currently enrolled participants to ensure they are eligible to receive or continue to receive our services.

Essential Job Duties:

• Assist both prospective and enrolled participants in applying for benefits and resolving any eligibility issues with SSI, Medi-Cal, and Medicare

• Develop positive relationships with County Medi-Cal and Social Security Administration staff, CMS, and the Department of Health Care Services staff, working proactively and collaboratively to resolve eligibility challenges

• Oversee enrollment and disenrollment transactions in line with CMS regulatory requirements

• Manage Part A and Part B applications during annual Medicare general enrollment periods and age-in periods, enabling collection of additional capitations

Job Requirements:

• Minimum of three (3) years of experience working in an administrative Medicare support role

• Strong knowledge of Microsoft Excel formulas and State systems (e.g., POS and AEVS, MARx, WIPRO, Gentran, RPC, ERPt)

• Experience interacting with local government Medicaid, Medicare or Social Security agencies preferred

Benefits of Working at WelbeHealth: Apply your expertise in meaningful ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for.

• Medical insurance coverage (Medical, Dental, Vision) starting day one of employment

• Work/life balance – we mean it! 17 days of personal time off (PTO), 12 holidays observed annually, sick time

• Advancement opportunities - We’ve got a track record of hiring and promoting from within, meaning you can create your own path!

• And additional benefits

Salary/Wage base range for this role is $70,000- $75,000 annually + Bonus + Equity. WelbeHealth offers competitive total rewards package that includes, 401k match, healthcare coverage and a broad range of other benefits. Actual pay will be adjusted based on experience and other qualifications.