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Medicaid Eligibility Representative information

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$32.5K

$55.3K

$91K

How much do medicaid eligibility representative jobs pay per year?

As of Aug 18, 2026, the average yearly pay for medicaid eligibility representative in the United States is $55,339.00, according to ZipRecruiter salary data. Most workers in this role earn between $45,000.00 and $63,500.00 per year, depending on experience, location, and employer.

What is a Medicaid Eligibility Representative?

A Medicaid Eligibility Representative is a professional who assists individuals in determining their eligibility for Medicaid benefits. They help applicants complete necessary forms, collect and verify documentation, and submit applications to the appropriate government agencies. These representatives also serve as a liaison between applicants, healthcare providers, and state agencies to ensure timely processing. Their goal is to ensure that qualified individuals receive the healthcare coverage they need through the Medicaid program.

What are the key skills and qualifications needed to thrive as a Medicaid Eligibility Representative?

To thrive as a Medicaid Eligibility Representative, you need knowledge of Medicaid programs, strong attention to detail, and experience with eligibility determination, often supported by a high school diploma or equivalent. Familiarity with case management software, state Medicaid systems, and document verification tools is typically required. Excellent interpersonal skills, empathy, and the ability to communicate complex information clearly help build trust with applicants and colleagues. These skills ensure accurate eligibility assessments, regulatory compliance, and positive client experiences in a complex healthcare environment.

What are some common challenges Medicaid Eligibility Representatives face when verifying applicant information?

Medicaid Eligibility Representatives often encounter challenges such as incomplete documentation from applicants, navigating complex eligibility criteria, and keeping up with frequently changing state and federal regulations. They must exercise strong attention to detail and problem-solving skills to ensure accurate verification and compliance. Effective communication and empathy are also vital, as representatives regularly interact with applicants who may be stressed or unfamiliar with the process.

What is the difference between Medicaid Eligibility Representative vs Medicaid Case Worker?

AspectMedicaid Eligibility RepresentativeMedicaid Case Worker
CredentialsHigh school diploma or equivalent; some roles may require certificationHigh school diploma or equivalent; additional certifications may be preferred
Work EnvironmentOffice settings, processing applications, verifying eligibilityOffice or community settings, providing case management and support
Employer & IndustryState Medicaid agencies, healthcare providersState Medicaid agencies, social service organizations
Primary FocusDetermining eligibility based on documentation and criteriaManaging cases, assisting clients with services and follow-up

Both roles involve working within Medicaid programs, but Medicaid Eligibility Representatives focus on verifying eligibility and processing applications, while Medicaid Case Workers provide ongoing support and case management. Understanding these differences helps job seekers identify the right position for their skills and career goals.

How to become a Medicaid Eligibility Representative?

To become a Medicaid Eligibility Representative, candidates typically need a high school diploma or equivalent and must complete relevant training or certification programs related to Medicaid policies and eligibility determination. Some positions require experience in social services or customer service, and familiarity with computer systems and data entry is often necessary.
More about Medicaid Eligibility Representative jobs

What cities are hiring for Medicaid Eligibility Representative jobs?

Cities with the most Medicaid Eligibility Representative job openings:

What states have the most Medicaid Eligibility Representative jobs?

States with the most job openings for Medicaid Eligibility Representative jobs include:

What job categories do people searching Medicaid Eligibility Representative jobs look for?

The top searched job categories for Medicaid Eligibility Representative jobs are:

Medicaid Eligibility Representative jobs near you
Infographic showing various Medicaid Eligibility Representative job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 18% Part Time, and 2% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $55,339 per year, or $26.6 per hour.

Onsite Medicaid Eligibility Representative

Revenue Group

Columbus, OH • On-site

$17.50/hr

Other

Re-posted 2 days ago

Job description

Pay Rate: $17.50/hr. plus monthly bonus after 90 days of up to $300
Hours: Monday-Friday 2:00pm-10:30pm including Holidays
Who is Hospital Referral Services?
No one wakes up in the morning and says, "Today I want to go to the hospital". We are here to help when the unexpected happens. Hospital Referral Services on-sites screen and help patient's bedside to see what assistance programs the uninsured or underinsured may be eligible to receive.
HRS's team of experts helps guide patients through the Medicaid process so the patient can focus on recovery.
Hospital Referral Services has an opening for an Onsite Medicaid Screening Representative at Ohio Health Riverside Methodist Hospital Emergency Room. We are looking for a self-motivated professional to add to our growing team. If helping people is something you enjoy, this may be the right job for you.
Our employees voted us Top Workplaces 4 years in a row!
The Onsite Medicaid Eligibility Representative will be responsible for:
  • Review the hospital work queue or census to identify uninsured patients that are admitted to the Emergency Room.
  • Screen/Interview patient's bedside in hospital setting to determine possible eligibility for any assistance programs available including Medicaid and charities.
  • High volume of walking and standing. (70% - 80% of your shift)
  • The Onsite Medicaid Screening Representative will complete applications for Medicaid benefits and charity programs as needed.
  • Maintain a positive working relationship with co-workers, hospital staff, and patients.
  • Abide by HIPAA rules and regulations to protect patient's privacy.
  • The Onsite Medicaid Screening Representative will meet production goals and objectives as assigned by hospital and management on a monthly basis.
  • Maintain confidentiality of account information at all times.
PM21
Requirements
Requirements for the Onsite Medicaid Eligibility Representative:
  • Previous customer service experience preferred.
  • Must have basic computer skills.
  • Must be able to multitask and type minimum 40 WPM
  • Must have reliable transportation.
  • Good attendance and dependability are essential.
  • Successful completion of drug and background test is required.
  • Annual Flu shots and TB testing is required

The Onsite Medicaid Eligibility Representative must have availability to work some holidays.
Please apply at: revenuegroup.com/careers
EEO Statement:
We are an Equal Employment Employer. We do not discriminate in hiring on the basis of sex, gender identity, sexual orientation, race, color, religious creed, national origin, physical or mental disability, protected Veteran status, or any other characteristic protected by federal, state/province, or local laws.
PM21
Salary Description
$17.50/hour

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