Eligibility Specialist

2 months ago


Dallas, United States Resource Center Full time
Job DescriptionJob DescriptionTitle: Eligibility Specialist                                                                           

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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