Benefits Eligibility Specialist

Spurwink; Portland (ME); On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

Health/Dental/Vision Insurance

Employer Paid Life Insurance

Retirement with Matching Contribution

Scholarships to ME Community Colleges

Tuition Reimbursement

Public Service Loan Forgiveness (PSLF)

Job summary

Spurwink in Portland, ME seeks a Benefits Eligibility Specialist to screen and verify healthcare coverage, benefits, and financial assistance, coordinating with clinical teams and payers to prevent gaps in care.

The role collaborates with clients to complete applications, monitor coverage changes, and document activities. A Bachelor's or Associate's degree with MHRT-C eligibility plus a valid driver’s license are preferred, with commitment to accessibility and quality care.

Qualifications

• Bachelor's degree in social services or related field, or Associate's degree with MHRT-c eligibility.
• Experience in social services, healthcare access, benefits navigation, or care coordination preferred.
• Valid driver's license with clean driving record.

Responsibilities

• Screen clients for healthcare coverage and financial assistance opportunities.
• Maintain client records meeting standards.
• Collaborate with clinical teams, payers, and community partners.
• Assist with applications for insurance and financial assistance.
• Track coverage status and changes to identify financial need.
• Provide outreach via phone, in-person meetings, and community events.
• Record and report data related to benefits screening.
• Support continuity of care by reducing gaps in coverage.
• Participate in supervision, trainings, and care team meetings.
• Maintain productivity and timely documentation.

Skills

Driver's license

Education

Bachelor's degree in social services or related field

Associate's degree with MHRT-c eligibility

Job description

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.

DUTIES:

• 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.

QUALIFICATIONS:

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.

Competitive Benefits Package:

• 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.