Eligibility and Financial Screening Specialist

Central Health; Northern (KY); Hybrid; USD 36,000 - 54,000; Full time

Job summary

Central Health in Kentucky is seeking an Eligibility Specialist to determine eligibility, assist with enrollment, and process state and federal applications for coverage. You will interview applicants, collect documents, and submit applications by mail, online, or in person while maintaining accurate records.

The role requires strong customer service, bilingual English/Spanish is highly preferred, and the ability to navigate complex programs and compliance standards.

Qualifications

• High School Diploma or equivalent required.
• 3 years experience in health care, government, non-profit, or a customer service industry.
• Bilingual English/Spanish preferred.

Responsibilities

• Interview applicants to collect demographic, financial information.
• Screen eligibility for local, state, and federal programs.
• Assist with enrolling eligible individuals and submitting applications.
• Maintain client records and enter data into eligibility databases.
• Educate clients on available programs and services.
• Attend community events as needed.
• Assist and troubleshoot applications submitted by mail or online.

Skills

Interpersonal skills

Customer service

Bilingual English/Spanish

Data entry

Analytical thinking

Critical thinking

Multitasking

Adaptability

Education

High School Diploma or equivalent

Tools

EMR systems

Microsoft Office Suite

Excel

Adobe Pro

Job description

Overview

Under general supervision, this role combines eligibility determination, financial screening, application assistance and enrollment services for local, state, and federally funded healthcare programs. This position is responsible for interviewing applicants, collecting and verifying required documentation, enrolling eligible individuals in appropriate programs and submitting state and federal applications for coverage. This position will assist patients/clients in-person, virtually, or by phone and will process applications submitted online or by mail and is responsible for maintaining accurate client records. This position requires exceptional customer service skills and the ability to navigate complex systems and compliance standards.

Responsibilities

Essential Duties:

• Interview applicants via video visits, phone calls, and in person in a professional manner to obtain demographic, financial, and household information.
• Screen and determine eligibility for local, state, and federal healthcare coverage programs and specialty funded programs and grants.
• Accurately apply the Eligibility Policies and Procedures to determine client eligibility and enroll eligible clients into the appropriate local and grant programs, and assist clients with submitting applications for state and federal health coverage programs.
• Maintain client files and contacts, and accurately enter data into eligibility databases and EMR systems.
• Submit, assist, and troubleshoot state and federal program applications.
• Educate clients on available programs, benefits, and services both in person and via phone or email.
• Answer incoming calls regarding Eligibility services and make outbound calls as needed.
• Attend community events and represent the organization as needed, including evenings and weekends.
• Identify and refer clients to additional services and community resources.
• Attend training and review all emails, newsletters and documents in order to stay current with changes in laws, regulations, and program eligibility requirements.
• Uphold the organization's values by consistently demonstrating professionalism in all actions, job performance, personal conduct, and communications.
• Perform other related duties as assigned.

Knowledge/Skills/Abilities:

• Strong interpersonal and customer service skills.
• Bilingual (English/Spanish) highly preferred.
• Proficiency in data entry and use of EMR, Microsoft Office Suite, Excel, and Adobe Pro.
• Know how to find information and ability to analyze information and evaluate results to choose the best solution.
• Knowledge of financial eligibility processes, regulatory standards, and specialty grants (Ryan White,
• Title V, PHC, Family Planning).
• Conflict resolution, problem-solving, and critical thinking abilities.
• Ability to work effectively with diverse populations and adjust actions based on client needs.
• Ability to multi-task and maintain attention to detail under pressure.

Qualifications

EDUCATION:

• High School Diploma or equivalent required.

EXPERIENCE:

• 3 years Experience working in health care, government, non-profit, or a customer service industry.