Eligibility Specialist; MAS​/ERB

Benefits Eligibility Specialist (MAS3/ERB)

This recruitment will be used to fill multiple positions.

Join our team as a Benefits Eligibility Specialist (Medical Assistance Specialist 3/MAS3) in the Employees and Retirees Benefits (ERB) Division. Support the PEBB and SEBB Programs by providing guidance on eligibility, insurance benefits, and enrollment through phone, email, and in-person interactions. Utilize a multi-line phone system, Benefits 24/7, and other tools to assist customers. We’re looking for someone with excellent communication, time management, and problem‑solving skills, who can thrive in a fast‑paced environment.

Apply today and improve health care services for Washington residents!

All HCA employees will apply an equity lens to their work, which may include but is not limited to all analyses of core business and processes.

The Employees and Retirees Benefits (ERB) Division manages a $5 billion budget to support over 725,000 individuals through two main programs. The Public Employees Benefits Board (PEBB) Program provides insurance and benefits to employees of state agencies, higher education institutions, and their dependents, including retirees and those eligible for COBRA. The School Employees Benefits Board (SEBB) Program offers coverage for employees of K‑12 schools, Educational Service Districts, Charter Schools, and their dependents, also providing COBRA continuation.

Both programs aim to improve health outcomes, care quality, and cost efficiency through value‑based purchasing and policies aligned with the Triple Aim framework.

This position aligns with the HCA mission and Governor's health care priorities by providing support in the delivery of quality customer service to PEBB and SEBB Programs’ subscribers and their dependents, including retirees, COBRA/continuation coverage, and K‑12 members. This position provides these services via a customer service phone line, an online member portal called “HCA Support,” email, mail, and in‑person at Cherry Street Plaza.

This position is eligible to telework part‑time and is required to report on site 1‑3 days a week to meet business need. The default assigned work location of all Health Care Authority (HCA) positions – both on‑site and telework eligible positions – is within the State of Washington.
This position reports to Olympia, WA
. Frequency of onsite work will vary based on business and operational needs. HCA has currently suspended the ability to support out‑of‑state telework.

• Utilize a multi‑line telephone and a toll‑free line to administer customer service.
• Use excellent communication skills and effectively communicate with customers and peers, utilizing a high degree of verbal and listening skills.
• Counsel customers on PEBB and SEBB Programs’ eligibility, policies, procedures, insurance benefits, rights and responsibilities, access to services, and enrollment status via phone, in‑person, email, and through our secure portal HCA Support.
• Assist customers in managing and navigating their electronic profiles and benefits elections in Benefits 24/7.
• Utilize various database systems and software programs, which include but are not limited to: HRISD/PAY1, Benefits 24/7, DRS Secure Client Remote Terminal (CRT), Avaya, Microsoft Office, Service Now, and AX imaging system, in the performance of all duties.
• Troubleshoot log‑in issues and direct customers with accessing their Benefits 24/7 account through Secure Access Washington (SAW).
• Independently analyze and process applications and documents for health benefits eligibility and enrollment.
• Participate in committee and project teams as requested. Some examples include participating in process improvement feedback and activities, employee resource groups, team meetings, or HCA materials reviews.
• Attend and complete training courses.

Qualifying candidates will meet one of the following criteria options:

• Bachelor’s degree.
• One (1) year of experience as defined below.

• Associate degree.
• Three (3) years of experience as defined below.

• Certificate of Medical Billing and Coding or closely…