Eligibility Specialist
2 months ago
Reports to: Non-Medical Case Management Manager
Position Overview:
Position is directly involved in establishing and documenting client eligibility for various programs and benefits
Job Duties & Responsibilities:
- Responsible for intakes, updates, and compliance
- Manage schedule of client appointments
- Research and resolve client eligibility issues thoroughly, timely, and accurately
- Respond timely to member eligibility inquiries from internal and external stakeholders
- Request necessary information to determine eligibility in a timely and accurate manner
- Maintains confidentiality of all business matters
- Maintain files for incoming eligibility documents and new client referrals
- Complete client enrollments and renewals
- Complete outcome measurements for clients
- Complete internal audits, preparations as needed for external audits
- Manually update member eligibility data in the Client Services database
- Manage emergency client renewals and requests for assistance
- Provide guidance to clients as a healthcare professional
- Refer clients to case managers that need additional services
- Other duties as assigned
Job Requirements & Qualifications:
- Associate’s degree or 3+ years in HIV field; experience may substitute for education
- 1 year of previous experience in determining Ryan White eligibility preferred.
- Familiarity with Microsoft Office applications
- Ability to work efficiently and effectively with clients from underserved populations
- Ability to work efficiently and effectively with a diverse set of co-workers
- Strong time management skills
- Excellent written & oral communication skills
- Excellent technical & business acumen
- Spanish-Speaking Preferred
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