Eligibility and Enrollment Specialist

5 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 (at least 5 that are non-negotiable duties and are absolutely pertinent to successfully completing the job without accommodations):

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:

MINIMUM EDUCATION: High School Diploma or equivalent


PREFERRED EDUCATION: Bachelors Degree


MINIMUM EXPERIENCE:
Three (3) years of related experience.

PREFERRED EXPERIENCE:
Experience assisting clients with applying for state or federal programs
Speak, read, and write Spanish fluently

REQUIRED CERTIFICATIONS/LICENSURE: N/A

PREFERRED CERTIFICATIONS/LICENSURE: N/A

REQUIRED COURSES/COMPLETIONS (e.g., CPR): N/A

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