Eligibility specialist vs medicaid specialist

The differences between eligibility specialists and medicaid specialists can be seen in a few details. Each job has different responsibilities and duties. It typically takes 1-2 years to become both an eligibility specialist and a medicaid specialist. Additionally, a medicaid specialist has an average salary of $44,308, which is higher than the $37,322 average annual salary of an eligibility specialist.

The top three skills for an eligibility specialist include medicaid, patients and provide technical assistance. The most important skills for a medicaid specialist are patients, home health, and medicaid eligibility.

Eligibility specialist vs medicaid specialist overview

	Eligibility Specialist	Medicaid Specialist
Yearly salary	$37,322	$44,308
Hourly rate	$17.94	$21.30
Growth rate	-	-
Number of jobs	19,944	73,368
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 49%	Bachelor's Degree, 53%
Average age	46	46
Years of experience	2	2

What does an eligibility specialist do?

An eligibility specialist is responsible for reviewing applicants' documents to verify their eligibility for qualifying for various organization programs. Eligibility specialists organize files accurately, communicate with other institutions for fact-checking, follow-up with the applicants for missing requirements, respond to the applicants' inquiries and concerns, and recommend alternatives, especially for financial assistance. An eligibility specialist must have excellent communication and record-keeping skills and extensive knowledge of the aid programs and company policies for processing applications.

What does a medicaid specialist do?

A Medicaid Specialist is a social service worker who focuses on assisting individuals when it comes to Medicaid programs. They are responsible for helping individuals understand the health care system procedures and requirements, answering inquiries, or referring them to other services. There are also Medicaid specialists who mostly perform clerical support tasks such as gathering and verifying documents, conducting research and analyses, handling calls and correspondence, reaching out to medical facilities and insurance companies, and maintaining records.

Eligibility specialist vs medicaid specialist salary

Eligibility specialists and medicaid specialists have different pay scales, as shown below.

	Eligibility Specialist	Medicaid Specialist
Average salary	$37,322	$44,308
Salary range	Between $30,000 And $45,000	Between $29,000 And $67,000
Highest paying City	Chicago, IL	-
Highest paying state	Iowa	-
Best paying company	CBIZ	-
Best paying industry	Government	-

Differences between eligibility specialist and medicaid specialist education

There are a few differences between an eligibility specialist and a medicaid specialist in terms of educational background:

	Eligibility Specialist	Medicaid Specialist
Most common degree	Bachelor's Degree, 49%	Bachelor's Degree, 53%
Most common major	Business	Business
Most common college	Northwestern University	University of Michigan - Ann Arbor

Eligibility specialist vs medicaid specialist demographics

Here are the differences between eligibility specialists' and medicaid specialists' demographics:

	Eligibility Specialist	Medicaid Specialist
Average age	46	46
Gender ratio	Male, 18.1% Female, 81.9%	Male, 16.7% Female, 83.3%
Race ratio	Black or African American, 14.1% Unknown, 3.8% Hispanic or Latino, 17.2% Asian, 8.1% White, 56.0% American Indian and Alaska Native, 0.8%	Black or African American, 21.6% Unknown, 4.2% Hispanic or Latino, 14.7% Asian, 7.8% White, 50.5% American Indian and Alaska Native, 1.2%
LGBT Percentage	7%	7%

Differences between eligibility specialist and medicaid specialist duties and responsibilities

Eligibility specialist example responsibilities.

Manage assignments of paying medical bills limit in depth that include organizing and researching regulations as pertain to veterans eligibility.
Demonstrate competency in basic understanding of Medicaid, policies, forms and DHS policy.
Coordinate these efforts by working with DES staff, other state agencies, FEMA and other volunteering private organizations.
Conduct Medicaid and TANF eligibility interviews.
Interview patients using multiple data base system to assess and determine Medicaid eligibility coverage for long term care services.
Experience with disability claim process as DHS eligibility worker desire.

Medicaid specialist example responsibilities.

Generate reports for managing compliance with Medicaid documentation in support of electronic billing to MCO
Acquire valuable expertise of HIPAA, Medicaid and patient confidentiality.
Provide excellent compassionate customer service to all patients, honoring patient privacy according to HIPAA regulations.
Review referrals and screen all uninsure patients seen at contract HCA hospitals for potential Medicaid and/or disability eligibility.
Adhere to all HIPPA laws.
Ensure ICD-9-CM, CPT, and HCPCS codes are correct for billing.

Eligibility specialist vs medicaid specialist skills

Common eligibility specialist skills

Medicaid, 14%
Patients, 11%
Provide Technical Assistance, 6%
Social Work, 5%
Data Entry, 5%
Community Resources, 4%

Common medicaid specialist skills

Patients, 23%
Home Health, 13%
Medicaid Eligibility, 13%
Rehabilitation, 9%
Social Work, 5%
Term Care, 4%

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Eligibility Specialist
Eligibility Specialist vs Medicaid Specialist

Updated January 8, 2025

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