Eligibility Specialist

Eligibility Specialist

The Eligibility Specialist is responsible for providing enrollment assistance and health coverage education to patients of The Health Care Connection (THCC) and members of the surrounding community. This role helps individuals understand their health insurance options and guides them through the application and enrollment process to obtain affordable healthcare coverage.

The Eligibility Specialist completes and submits applications for Medicaid, Marketplace health insurance plans, and Presumptive Eligibility for Medicaid while ensuring accuracy, confidentiality, and compliance with federal and state regulations. The position serves as a trusted resource by educating patients on eligibility requirements, assisting with renewals and changes in coverage, and connecting individuals with appropriate healthcare resources to improve access to care.

• Provides enrollment assistance for uninsured adults and children to access subsidized, low-cost and free health insurance programs through the "Health Insurance Marketplace" and benefits.gov for Medicaid
• Provides structured health care outreach and education to patients on A.C.A. related coverage options and obligations.
• Distributes outreach materials to patients, community members, partner organizations and business to build coverage awareness as dictated by the "Outreach Plan".
• Attends community events in order to promote coverage availability, coverage options and to promote enrollment.
• Collaborates with local organizations to build awareness of coverage options, share best practices and to assist during enrollment events.
• Works closely with Ohio Medicaid, county Job & Family Service agencies, public health organizations, hospitals and community outreach staff as necessary.
• Attends and successfully completes all required training programs, participates in ongoing educational conference calls, webinars and other professional development opportunities.
• Provides accurate reports and tracking on enrollment and outreach practices for HRSA, the CEO and Board of Trustees.
• Travels between health center sites to maximize patient enrollment/education
• Performs other necessary duties supported by grant funding

• High School graduate plus minimum of two years of college education/course completion
• Two years previous experience working in the public sector with diverse populations, knowledgeable regarding social services and public health services. Knowledge of government backed health coverage programs as well as managed care companies serving this region may be considered in lieu of college education.