Eligibility Specialist

The Benefits Eligibility Specialist is a specialized Case Manager who works directly with clients to screen and verify benefits and insurance eligibility, navigates financial assistance and healthcare coverage options, and coordinate with clinical teams, payers, and community partners. Through ongoing monitoring of coverage status, accurate documentation, and client‑centered education, the role helps prevent gaps in care and supports consistent access to needed services.

• Maintain client records and documentation according to Spurwink, financial, billing, regulatory, and licensing standards.
• Screen appropriate clients for healthcare coverage, public benefits, and financial assistance opportunities.
• Assist clients and families in understanding healthcare coverage, benefits, and financial responsibilities.
• Assist clients in completing insurance and financial assistance applications.
• Perform routine and ongoing review of clients to identify changes in coverage status or financial need.
• Maintain regular contact with clinical teams and community professionals involved with the client.
• Provide support through phone contact, in-person meetings, and community‑based outreach.
• Record, track, and prepare required data related to benefits screening and outreach activities.
• Support organizational sustainability and continuity of care by assisting clients in maintaining active healthcare coverage and benefits, utilizing established workflows, technology, and tools to reduce avoidable gaps in coverage that may create barriers to treatment engagement.
• Participate in supervision, trainings, and interdisciplinary care team meetings.
• Maintain productivity expectations and documentation timeliness.

Bachelor's degree from an accredited four (4) year institution of higher learning with a specialization in social services or closely related field, or Associate's degree and MHRT‑c eligibility, depending on the program requirements. Experience in social services, healthcare access, benefits navigation, or care coordination preferred. Must maintain a current driver's license and a clean driving record as outlined in Spurwink's Driving Policy.

• Health/Dental/Vision /Pet Insurance
• Employer Paid Life Insurance and Short/Long Term Disability
• Retirement Account with Matching Contribution (after one year of service)
• Scholarships to ME Community Colleges
• Tuition Reimbursement
• 25% Tuition Reimbursement for UNE Master of Social Work Program
• Eligible employer for the Public Service Loan Forgiveness (PSLF) Program
• Quality Supervision and Paid Training Opportunities
• Career Advancement Opportunities
• Flexibility of Schedules
• Generous Paid Time Off
• Opportunity for Same Day Pay
• Health Plan Enrollees - Access to Several Discounts (Hotels, Electronics, Auto, Groceries, Event Tickets, and More)

Spurwink is an Equal Opportunity Employer.