Eligibility Enrollment Specialist

Texas Health Action; Austin, Northern (TX, KY); Hybrid; USD 26,000 - 36,000; Part time

Job summary

Texas Health Action is seeking an Eligibility Enrollment Specialist to assist patients in identifying, applying for, and maintaining eligibility for internal and external programs. The role covers screening, documentation, enrollment, and coordination with clinic teams to reduce barriers to care.

This is a fixed 6-month, 1099 independent contractor position with no employee benefits. The position supports Austin, San Antonio, and remote candidates residing in Texas, with typical Monday–Friday

Qualifications

• High school diploma or equivalent; degree preferred.
• Minimum 1 year experience in healthcare, patient services, benefits navigation, enrollment, or related role.
• Experience assisting individuals with applications for healthcare coverage or community programs.
• Experience reviewing eligibility documentation (income, residency, insurance).
• Bilingual English/Spanish preferred.
• Demonstrated professionalism with diverse populations.

Responsibilities

• Conduct comprehensive eligibility screenings for internal and external programs.
• Verify income, residency, household, and insurance information.
• Assist enrollment/renewal for Central Health MAP and MAP Basic.
• Screen and enroll in THA internal programs and other resources.
• Help complete applications and gather supporting documents.
• Educate patients about programs, eligibility, benefits, and renewal timelines.
• Track applications, referrals, determinations, approvals, denials, and renewals.
• Follow up to obtain missing information and prevent delays.
• Maintain documentation in approved systems.
• Coordinate with clinic teams to facilitate care access after enrollment.
• Maintain knowledge of programs and eligibility criteria.

Skills

Customer service

Bilingual English/Spanish

HIPAA compliance

Documentation

Benefits navigation

Education

High school diploma or equivalent

Associate or bachelor’s degree preferred

Tools

VeritySource

Central Health MAP

Job description

Texas Health Action (THA) is a community-informed non-profit organization dedicated to providing access to culturally affirming, quality health services in a safe and supportive environment, with expertise in serving LGBTQIA+ people and those impacted by HIV. Kind Clinic proudly serves Texas with four vibrant locations: two in Austin, one in San Antonio, and another in Dallas plus virtual care services available to all residents across Texas. Bolstered by Waterloo Counseling Center and a passionate team of over 250 dedicated employees and volunteers, THA is at the forefront of promoting healthcare equity and accessibility throughout the state. Read more about THA here: http://texashealthaction.org.

Texas Health Action is seeking applicants for an Eligibility Enrollment Specialist, working under the direction of the Director of Patient Support Services. The Eligibility Enrollment Specialist is responsible for assisting patients and community members with identifying, applying for, enrolling in, and maintaining eligibility for Texas Health Action internal assistance programs and external healthcare and community assistance programs.

This is a fixed 6-month position. This role is engaged as a 1099 independent contractor position and does not include employee benefits (e.g., health insurance, paid time off, retirement contributions).

Schedule: Monday–Friday, during clinic hours, or part-time as needed."

This position provides direct patient support to reduce financial, administrative, and access-related barriers to care. The Eligibility Enrollment Specialist conducts eligibility screenings, verifies required documentation, educates patients about available programs, completes and submits applications, coordinates referrals, and follows applications through determination and renewal.

Programs may include Central Health’s Medical Access Program (MAP) and MAP Basic, Texas Health Action assistance programs, medication and pharmaceutical assistance programs, healthcare coverage resources, and other local, state, federal, nonprofit, or community-based programs for which patients may qualify.

This position is available in Austin (Central and South locations), San Antonio, and remotely for candidates residing in Texas.

Core Functions

• Conduct comprehensive eligibility screenings to identify internal and external assistance programs for which patients may qualify.
• Verify income, residency, household composition, insurance status, and other documentation required to establish program eligibility.
• Assist patients with enrollment and renewal for Central Health MAP and MAP Basic, including completing and submitting applications through the Central Health/VeritySource system.
• Screen and enroll eligible patients in Texas Health Action internal assistance programs and other organizational resources designed to improve access to care.
• Assist patients with completing applications, gathering supporting documentation, submitting required materials, and navigating enrollment systems.
• Educate patients about available programs, eligibility requirements, benefits, required documentation, renewal timelines, and responsibilities for maintaining eligibility.
• Help patients understand their available assistance options and determine which programs best meet their healthcare and financial needs.
• Track pending applications, referrals, eligibility determinations, approvals, denials, and renewals through completion.
• Proactively follow up with patients to obtain missing information or documentation and help prevent delays or interruptions in assistance.
• Assist patients with resolving enrollment barriers, including incomplete applications, documentation issues, eligibility questions, requests for additional information, and denials.
• Maintain accurate and timely documentation of screenings, applications, referrals, enrollment outcomes, and patient interactions in approved electronic systems.
• Coordinate with clinic teams, Patient Support Services and other departments to facilitate access to care following enrollment or approval.
• Maintain current knowledge of internal and external assistance programs, including eligibility criteria, benefits, application procedures, documentation requirements, and renewal processes.
• Maintain familiarity with community resources that address barriers to healthcare and other supportive service needs.
• Provide patient-centered and culturally responsive assistance while helping individuals navigate complex eligibility and enrollment processes.
• Maintain compliance with HIPAA, organizational privacy and confidentiality standards, program requirements, and applicable regulations.
• Identify recurring eligibility and enrollment barriers and communicate trends and resource gaps to Patient Support Services leadership.
• Perform other eligibility determination, enrollment, patient assistance, benefits navigation, and resource coordination duties as assigned.

Compensation

Based on the position’s duties and requirements, this role has a starting hourly rate of $22.93. The initial hourly rate will be determined by the selected candidate’s qualifications and relevant experience.

• High school diploma or equivalent required; associate or bachelor’s degree in healthcare, social services, public health, human services, or a related field preferred.
• Minimum of 1 year of experience in healthcare, patient services, benefits navigation, eligibility determination, enrollment, financial assistance, case management, or a related customer service role preferred.
• Experience assisting individuals with applications for healthcare coverage, financial assistance, public benefits, medication assistance, or community-based programs preferred.
• Experience reviewing and verifying eligibility documentation, including income, residency, household, and insurance information.
• Experience working directly with patients or clients from diverse backgrounds and navigating sensitive financial or personal circumstances with professionalism and discretion.
• Bilingual English/Spanish skills preferred.

Applicant Information

• Submitting official transcripts, diplomas, certifications and licenses may be required prior to final offer. Unofficial transcripts and copies of other relevant documents may be attached to the application for consideration in advance.
• Information regarding employment history as it relates to the qualifications of the position may be needed for employment verification.
• The applicant selected for employment is subject to a pre-employment background check. A history of conviction may not automatically disqualify an applicant. Applicants with a history of conviction may be considered on a case-by-case basis, after individualized assessment of factors including the nature of the conviction, the job duties and responsibilities, the length of time since the conviction, and evidence of mitigation or rehabilitation. If required for the position, a physical, motor vehicle record evaluation, and additional background checks may be conducted.

EEO Statement: Texas Health Action is proud to be an Equal Employment Opportunity and Aff…