Medicaid Benefits Counselor
Job Type

Non- Exempt $16.32 Per hour We offer a comprehensive benefits package which includes Medical, dental, vision fully funded by SRA, Paid Time off , 401K and more!


This is a call center position. The Medicaid Benefits Counselor provides long-term care program education and completes assessments for long-term care programs for the aged and disabled in our region. This position performs activities that facilitate access to and the determination of Medicaid eligibility for individuals seeking services. This position is 100% Medicaid-related.


  • Performs activities that facilitate access to and the determination of Medicaid eligibility for individuals seeking services. Expedites the individual’s application for determination of eligibility and participation or maintenance in the Statewide Medicaid Managed Care Long Term Care (SMMC) Medicaid program.
  • Verify an individual’s current Medicaid eligibility status for purposes of the Medicaid eligibility process and tracks Medicaid applications through the eligibility process.
  • Provide efficient, timely and consumer friendly services to facilitate the eligibility and review process.
  • Conduct comprehensive screening on Medicaid probable individuals on the Assessed Priority Client List (APCL) who are not active in a case managed program.
  • Input client assessments into CIRTS (Client Information Registration Tracking System).
  • Post information in the enrollment and termination screens of CIRTS to update the APCL, as needed.
  • Acquire forms and compile required documentation; providing technical assistance; coordinating with eligibility determination professionals; and performing all other duties related to completing and submitting a client’s Medicaid application.
  • Refer clients to the local Department of Children and Families (DCF) staff to make application for Medicaid benefits and work with DCF staff to facilitate the process.
  • Obtain the Physician Referral Form (3008) for Medicaid probable individuals and coordinate with the Department of Elder Affairs case managers (CARES) staff for determination of a client’s functional eligibility - Level of Care (LOC).
  • Contact individuals on the APCL as required to update information and screen for Medicaid eligibility.
  • Perform other Medicaid-related duties as assigned, which may include counseling disaster victims about Medicaid programs, options and eligibility process.

The above statements are intended to describe the nature of the level of work to be performed by the individual(s) assigned to this position. Other tasks may be assigned by supervisory staff and senior management.



  • Four Year College Degree or High school diploma and three years’ experience in I&R services, Medicaid case management, call center services, social services; or related work
  • Eligible to become certified as an Information and Referral Specialist. Must successfully complete DOEA Client Assessment Training with passing score.
  • Ability to complete and receive a passing score in Uniform Client Assessment Training within 90 days of employment
  • Excellent written and verbal communication skills.
  • Proficiency in Microsoft Office: Word, Excel, Power Point, Outlook (required).
  • Ability to research topics related to services for older adults (funding, program design, etc.), analyze data and provide written and/or oral reports as required.


The incumbent generally works in an office or home office environment, uses computers, telephone and other office equipment as needed to perform duties. The noise level in the environment is usually moderate.

Sedentary work primarily involves sitting and standing. Required to use repetitive hand motion, talk, handle, reach, hear, bend or lift up to 20 pounds.

The physical demands are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.