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Become An Eligibility Specialist

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Working As An Eligibility Specialist

  • Getting Information
  • Documenting/Recording Information
  • Organizing, Planning, and Prioritizing Work
  • Communicating with Supervisors, Peers, or Subordinates
  • Performing for or Working Directly with the Public
  • Deal with People

  • Unpleasant/Angry People

  • Stressful

  • $30,830

    Average Salary

What Does An Eligibility Specialist Do At Kelly Services

* Review incoming referrals for completeness of and confirm FDA requirements are met.
* These are typically received via facsimile, Web portal or client partner download.
* Place outbound calls to doctors, patients, and insurance companies
* Prepare patient file and attach all necessary documentation and correspondence and assign referral to the appropriate RA/CSR.
* Make calls to connect call to patient/family to introduce our program and screen for eligibility for free drug program.
* Reopen cases in database as requested for Insurance changes and re-authorizations as they expire.
* Accurately enter orders for drug placed by phone and fax from home care centers and pharmacies.
* Answer inquiries regarding status of orders placed.
* Generate and mail brochures, letters and patient authorization forms to patients for completion, as well as follow up letters for same.
* Send fax updates to physicians

What Does An Eligibility Specialist Do At Housing Authority for The City of Austin

* Conducts yearly and interim interviews of residents family income and household composition to determine continued eligibility and benefit level.
* Schedules re-exam appointment, collects documentation, makes revisions, calculates rent adjustments, notifies residents and landlords orally and/or in writing.
* Writes up leases and contracts, obtains client and owner signatures, documents and compiles file, and submits for case screening.
* Answers resident and landlord inquiries and mediates problems between tenants and owners.
* Maintains client records on computer and in case files, provides clients with resources and referral information needed to work towards self-sufficiency.
* Other related duties as assigned

What Does An Eligibility Specialist Do At Common Ground

* Prepare/Send/Track Interview Invite letters to eligible applicants
* Schedule and conduct applicant Interviews
* Facilitate collection and submission of required applicant documents, Request and/or Collect Required Documents (Contact applicants to update documents as needed)
* Perform credit/criminal background checks, determine initial eligibility of applicants and send initial eligible and ineligible letters to applicants
* Request & review initial verifications of applicants' housing/income/assets (applicants & 3rd parties)
* Assemble File for transfer to Leasing Specialist
* Performs other related duties as assigned (e.g. unit showings, lease signings, reporting, administrative tasks, prepare subsidy packets etc

What Does An Eligibility Specialist Do At Pacific Dental Services, LLC

* Call insurance carriers.
* Access insurance carrier and/or affiliated websites.
* Obtain eligibility and benefit breakdown.
* Enter eligibility and benefit breakdown information into a central database and/or other locations.
* Maintain performance.
* Report to Manager any issues, trends, and/or challenges associated with eligibility and/or benefit.
* Interact with fellow Eligibility and Benefits Team members in regards to best practices.
* Work from a queue of office inquiries regarding any issues and/or requests.
* Maintains an appropriate professional appearance and demeanor in accordance with Company policies.
* Ensure compliance with Company policies, as well as State, Federal and other regulatory bodies.
* Participate in meetings as required.· Bring forth ideas to improve processes and materials

What Does An Eligibility Specialist Do At Texas Employer

* 1. Adheres to the mission of SERCO.
* Maintains working knowledge of the statement of work, performance payment conditions, and performance goals as well as the implementation and spirit of the Workforce Innovation and Opportunity Act.
* Develops and implements alternative methods for improvement of goals and objectives.
* Works with management team to establish standards of excellence using qualitative and quantitative methods.
* Provides step-by-step written and oral guidance for achievement of excellence in the selected areas.
* Identifies best practices among SERCO managed workforce centers and communicates findings to SERCO management as well as throughout the SERCO workforce center network.
* Perform all aspects of eligibility determination and documentation for various federal, state and grant-funded programs.
* Maintains up-to-date knowledge of state and federal laws and rules pertaining to Board programs and activities.
* Additionally, responsible for dissemination of this information to contractors through regular communication and technical assistance trainings.
* Receives and reviews application materials and other source documents for accuracy, completeness and consistency.
* Reviews and oversees the work of staff engaged in verifying processes and procedures in order to assure that customers are eligible for Workforce programs.
* Reviews the processes through data gathering, data review and analysis, document review, verification, criteria/development, and preparation of work papers.
* Identify and report, to the assistant manager, data which does not meet eligibility criteria.
* Works with confidential material and ensures that information is protected/secured as mandated by local, state, and federal policy.
* Sorts documents and provides necessary copies and information to file clerk and career counselor as necessary

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How To Become An Eligibility Specialist

Requirements for social and human service assistants vary, although they typically have at least a high school diploma and must complete a brief period of on-the-job training. Some employers prefer to hire workers who have additional education or experience.

Education

Although a high school diploma is typically required, some employers prefer to hire workers who have relevant work experience or education beyond high school. A certificate or an associate’s degree in a subject such as human services, gerontology (working with older adults), or social or behavioral science is common for workers entering this occupation.

Human service degree programs train students to observe and interview patients, carry out treatment plans, and handle people who are undergoing a crisis. Many programs include fieldwork to give students hands-on experience.

The level of education that social and human service assistants have completed often determines the responsibilities they are given. Those with a high school diploma are likely to do lower level work, such as helping clients fill out paperwork. Assistants with some college education may coordinate program activities or manage a group home.

Although postsecondary education is important, some employers may prefer or allow for applicants who have related work experience. In some cases, candidates may substitute such experience in place of postsecondary education. 

Training

Many social and human service assistants, particularly those without any postsecondary education, undergo a period of on-the-job training. Because such workers often are dealing with multiple clients from a wide variety of backgrounds, on-the-job training in case management helps prepare them to respond appropriately to the different needs and situations of their clients.

Advancement

For social and human service assistants, additional education is almost always necessary for advancement. In general, advancement to case management or social work jobs requires a bachelor’s or master’s degree in human services, counseling, rehabilitation, social work, or a related field.

Important Qualities

Communication skills. Social and human service assistants talk with clients about the challenges in their lives and assist them in getting help. These workers must be able to listen to their clients and to communicate the clients’ needs to organizations that can help them.

Compassion. Social and human service assistants often work with people who are in stressful and difficult situations. To develop strong relationships, they must have compassion and empathy for their clients.

Interpersonal skills. Social and human service assistants must make their clients feel comfortable discussing sensitive issues. Assistants also need to build relationships with other service providers to become familiar with all of the resources that are available in their communities.

Organizational skills. Social and human service assistants often must complete lots of paperwork and work with many different clients. They must be organized in order to ensure that the paperwork is filed properly and that clients are getting the help they need.

Problem-solving skills. Social and human service assistants help clients find solutions to their problems. They must be able to listen carefully to their clients’ needs and offer practical solutions.

Time-management skills. Social and human service assistants often work with many clients. They must manage their time effectively to ensure that their clients are getting the attention they need.

Some employers require a criminal background check. In some settings, workers need a valid driver’s license.

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Eligibility Specialist jobs

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Top Skills for An Eligibility Specialist

MedicaidPublicAssistanceProgramsCustomerServiceIssuesTanfDataEntryDeterminesEligibilityChildCareMedicalAssistanceEligibilityRequirementsPhoneCallsSocialServicesClientDataDisabilityProcessApplicationsClientEligibilityClientInformationFinancialAssistanceSocialSecurityHealthInsuranceCommunityResources

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Top Eligibility Specialist Skills

  1. Medicaid
  2. Public Assistance Programs
  3. Customer Service Issues
You can check out examples of real life uses of top skills on resumes here:
  • Process Children's Medicaid applications using State of Texas eligibility criteria.
  • Provided information to Eligibility Consultant who makes the eligibility decision for various Public Assistance Programs.
  • Resolved case errors, customer service issues, and worked in a team environment.
  • Processed applications for Medicaid, food stamps, and TANF - Conducted interviews with applicants to determine eligibility
  • Determine eligibility for plan members, * Data Entry for pharmacy order changes * Confirm pharmacy orders via physician palm pilots

Top Eligibility Specialist Employers

Eligibility Specialist Videos

So You Want To Be An Elgibility Worker?""

VA Loan Certificate of Eligibility

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