Eligibility and Enrollment Specialist

4 months ago

Austin, United States Central Health Full time

Overview:

Under general supervision, refers, enrolls and/or assists customers in obtaining appropriate local or state funded healthcare coverage, and assists customers in resolving complex problems and complaints. Performs out stationed eligibility duties including submitting, tracking and troubleshooting State program applications.

This position is considered Hybrid, which means that individuals in this position may work both at an approved Offsite location and Onsite at a primary location or multiple locations based on Business Needs

Responsibilities:

Essential Duties:

  • Interview applicants in a professional and courteous manner to obtain appropriate demographic and household information needed in order to screen clients for appropriate healthcare coverage programs.
  • Accurately enter client data, and collect, verify and scan appropriate documents into the eligibility database according to Eligibility Policies and Procedures.
  • Accurately apply the Eligibility Policies and Procedures to determine client eligibility and enroll eligible clients into the appropriate local and grant programs and assist clients with submitting applications for state and federal health coverage programs.
  • Track enrollment and troubleshoot State program applications as assigned.
  • Inform and educate clients on program benefits, in person, over the phone, or through email.
  • Pay attention to details.
  • Ability to work some weekend work, covering the Eligibility Call Center.


Knowledge/Skills/Abilities:

  • Adding, subtracting, multiplying or dividing quickly and correctly and to understand and organize a problem and then to select a mathematical method or formula to solve the problem.
  • Using relevant information and individual judgment to determine whether events or processes comply with laws, regulations, or standards.
  • Work effectively with individuals from diverse backgrounds.
  • Administrative and clerical procedures and systems such as word processing and data base systems, and other office procedures and terminology.
  • Interviewing techniques and proper interviewing etiquette.
  • Conflict resolution techniques.
  • Analyzing information and evaluating results to choose the best solution.
  • Knowing how to find information and identifying essential information.
  • Communicating effectively in speaking and writing as indicated by the needs of the audience.
  • Coordinating activities by adjusting actions in relation to others' actions.
  • Being aware of others' reactions and understanding why they react the way they do.
  • Performing basic operations in Microsoft Office Suite.
  • Listening to what other people are saying and asking questions as appropriate.
  • Actively looking for ways to help people and establishing and maintaining effective working relationships.
  • Efficiently shift back and forth between two or more activities or sources of information.
  • Correctly follow a given rule or set of rules in order to arrange things or actions in a certain order including procedures, orders or logical operations.
  • Use deductive reasoning to apply general rules to specific problems to come up with logical answers and decide if an answer makes sense.
  • Communicate information and ideas in speaking and writing so others will understand.
Qualifications:

EDUCATION:

  • High School Diploma or equivalent required.
  • Bachelors Degree preferred.


EXPERIENCE:

  • Three (3) years of related experience required.
  • Experience assisting clients with applying for state or federal programs preferred.
  • Speak, read, and write Spanish fluently preferred.

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