Eligibility Specialist

Job Description

Job Description

Description

Make a meaningful impact helping individuals and families access the healthcare coverage they deserve.

As an Eligibility Specialist, you’ll be a trusted resource in our rural communities — supporting patients and community members in understanding health insurance options and enrolling in coverage that helps them stay well. You’ll provide education at our centers and out in the community, ensuring individuals have the knowledge and confidence to use their benefits to live healthier lives.

This is a great opportunity for someone who is passionate about connecting people with care, enjoys engaging with the community, and thrives in a role that blends outreach, education, and direct support.

Key Responsibilities

• Monitor uninsured health center patients annually to ensure they are screened for eligibility 
• Provide education to health center staff about insurance options so they can assist in educating their patients
• Assist patients with enrollment in MO HealthNet, CHIP and other public health insurance options • Assist patients with appeals and hearings related to MO HealthNet, CHIP and other public health insurance options coverage issues
• Support patients in submitting requested documents for case processing
• Educate patients on utilization of their health insurance coverage, including how to maintain coverage, what is covered and how to coordinate care
• Assist with submitting address updates
• Complete all required trainings, participate in all meetings assigned, complete all required reporting
• Assist with Annual Renewal forms
• Support patients in removing incarceration lock-in’s, Child Support Sanctions, and third-party payers from Medicaid coverage
• Meet productivity expectations related to application numbers, paperwork error rates and answering shared phone queue calls
• Enter work into shared database timely as well as enter Medicaid screenings into EHRs
• Support all departments within the organization with insurance eligibility and assist in confirming active patient coverage 

Requirements, Skills, Knowledge and Expertise

• High School/GED required
• Bachelor’s degree preferred

  Licensure/Certification
• State of Missouri Insurance Navigator’s licensure required within 6 months of hire
• Federal Certified Application Counselor or Federal Navigator’s licensure required within 6 months of hire

You’ll be a great fit for this role if you:

• Enjoy public speaking and building rapport with diverse audiences
• Bring a compassionate, strength-based approach to helping others
• Are organized and comfortable working independently in the community
• Have a natural curiosity for learning program updates and sharing knowledge with others
• Are committed to reducing barriers to care and advancing wellness in underserved areas