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Medicaid Eligibility Quality Assurance Specialist

HCA Healthcare • Nashville, Tennessee, United States

remotefull-time
Posted Oct 29, 2026Apply by Nov 28, 2026

**Role & Seniority: ** Medicaid Quality Eligibility Specialist (mid-level; requires 3+ years Medicaid eligibility advocate experience)

**Stack/Tools: **

  • Microsoft Office (incl. Excel, Word)

  • QA/data review using eligibility operations systems (tools/systems not explicitly named)

  • Reporting/documentation and forms

  • Top 3 Responsibilities:

    • Perform quality assurance for Medicaid eligibility operations to meet customer requirements; audit assigned accounts on a schedule

    • Conduct analytical assessments of eligibility data and support management with data-driven decision-making

    • Document, report, and coordinate follow-up on QA findings with internal/external departments; recommend process improvements to meet standards

  • Must-have Skills:

    • 3+ years Medicaid eligibility advocacy experience

    • Medicaid eligibility experience, preferably both hospital-based screening and application processing

    • Intermediate–advanced Excel and Word proficiency; standard Microsoft Office skills

    • Ability to work independently, multi-task, maintain accurate organized documentation, and meet timelines

    • Strong coordination skills across departments; ability to make improvement recommendations

  • Nice-to-haves:

    • (Not explicitly stated) Experience with larger revenue cycle / revenue integrity workflows; broader QA program ownership
  • Location & Work Type:

    • Work from home (re

Full Description

Schedule ; Mon -Fri - 7: 30 am -4:30 pm

Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Submit your application for the opportunity below: Medicaid Quality Eligibility Specialist

Job Summary And Qualifications

In this role you will

Must have 3 years of Medicaid eligibility Advocate experience Perform quality assurance activities for Medicaid eligibility operations to ensure that work efforts satisfactorily meet customer requirements in a systematic, reliable fashion, effectively using systems to do so. Perform analytical assessments of data and assist the management team in using the data for decision-making purposes. Maintain prompt and accurate documentation outlining all steps of the QA program that have been taken in individual organized files. Complete the proper forms. Audit the assigned number of accounts per day following a set schedule. Forms will be completed and submitted within required timelines. Work independently with various departments to ensure revenue is maximized. Maintain reports that are indicative of process improvement within departments while promoting a positive presence in improving these processes. Make recommendations based on assessments that improve production and quality. Ability to multi-task to ensure day-to-day work is complete as well as assigned projects. Coordinate QA findings with appropriate departments, internal or external, and ensure that necessary follow up is done to resolve any negative results. Provide documented results and process improvement to Director for departments not meeting company/client standards. Perform special projects or other activities as assigned. Establish and maintain constructive working relationships with coworkers, supervisors, managers and executives, as well as external clients and other external business contacts.

Qualifications

Minimum of 3 years’ experience within Medicaid Eligibility, preferably as both a hospital-based screener and an application processor. Experience with standard suite of Microsoft office software products. Intermediate to advanced proficiency with Excel and Word required. Work from home roles require employees must have high speed internet 60 MB download and 10 MB upload.

Benefits

Work from Home, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include

Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services Wellbeing support, including free counseling and referral services Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn More About Employee Benefits

Note: Eligibility for benefits may vary by location.

Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"There is so much good to do in the world and so many different ways to do it."- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

If you find this opportunity compelling, we encourage you to apply for our Medicaid Quality Eligibility Specialist opening. We promptly review all applications. Highly qualified candidates will be directly contacted by a member of our team. We are interviewing - apply today!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

Account AuditingApplication ProcessingCross-Department CoordinationData AnalysisDocumentationHospital-Based ScreeningMedicaid EligibilityMicrosoft ExcelMicrosoft OfficeMicrosoft WordMultitaskingProblem ResolutionProcess ImprovementQuality AssuranceReport PreparationRevenue Cycle Management

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