Eligibility Specialist

The HealthCare Connection Inc.; Mount Healthy (OH); On-site; USD 38,000 - 55,000; Full time

Benefits offered by this job

Health Insurance

Dental Insurance

Vision Insurance

Life & Disability Insurance

403(b) Retirement Plan with employer 1

Job summary

The HealthCare Connection in Ohio seeks an Eligibility Specialist to assist patients with health coverage options and enrollment. You will guide consumers through Medicaid, Marketplace plans, and presumptive eligibility while ensuring accuracy and confidentiality.

Responsibilities include renewals, changes in coverage, outreach activities, and collaboration with local agencies to improve access to care.

Qualifications

• Two years of college education or coursework completed.
• Experience helping diverse populations access health coverage.
• Knowledge of Medicaid and Marketplace programs is a plus.
• Ability to explain eligibility requirements clearly.

Responsibilities

• Provides enrollment assistance for uninsured adults and children.
• Educates patients on ACA coverage options and obligations.
• Distributes outreach materials to build coverage awareness.
• Attends community events to promote enrollment availability.
• Collaborates with local organizations to raise awareness of options.
• Coordinates with Ohio Medicaid and public service agencies as needed.
• Completes required training and maintains program knowledge.
• Reports enrollment and outreach data for grant and leadership review.

Skills

Enrollment Assistance

Patient Education

Regulatory Knowledge

Community Outreach

Education

Two years of college education

Job description

Career Opportunity: Eligibility Specialist

Reports to: CFO

Organization: The HealthCare Connection (THCC)

Location: Mt. Healthy

About The HealthCare Connection:

Founded in 1967, The HealthCare Connection was Ohio’s first Federally Qualified Health Center (FQHC). Our mission is to provide quality and accessible primary healthcare services through community responsive approaches that address financial, geographic, and other barriers to care for residents of northern Hamilton County and surrounding areas. THCC is proudly recognized as a Level 3 Patient Centered Medical Home (PCMH), the highest level of recognition attainable for quality care.

We boast two primary care locations and 6 school-based health centers providing quality value-based care for over 20,000 patients. We provide services in Primary Care, Infectious Disease, Substance Use, Integrated Behavioral Health, Dental Services, Women’s Health, and Pharmacy.

• Health Insurance and Rewards Program
• Dental, and Vision Insurance
• Free Life & Short-Term Disability Insurance
• 403(b) Retirement Plan with employer match
• 10 Paid Holidays

Position Summary:

The Eligibility Specialist is responsible for providing enrollment assistance and health coverage education to patients of The Healthcare Connection (THCC) and members of the surrounding community. This role helps individuals understand their health insurance options and guides them through the application and enrollment process to obtain affordable healthcare coverage.

The Eligibility Specialist completes and submits applications for Medicaid, Marketplace health insurance plans, and Presumptive Eligibility for Medicaid while ensuring accuracy, confidentiality, and compliance with federal and state regulations. The position serves as a trusted resource by educating patients on eligibility requirements, assisting with renewals and changes in coverage, and connecting individuals with appropriate healthcare resources to improve access to care.

Key Responsibilities:

• Provides enrollmentassistancefor uninsured adults and children to access subsidized,low-costand free health insurance programs through the “Health Insurance Marketplace” and benefits.gov for Medicaid
• Provides structuredhealth care outreach and education to patients on A.C.A. related coverage options and obligations.
• Distributes outreach materials to patients, community members, partnerorganizationsandbusinessto build coverage awareness as dictated by the “Outreach Plan”.
• Attends community eventsin order topromote coverage availability, coverage options and to promote enrollment.
• Collaborates with local organizations to build awarenessof coverage options, share best practices and toassistduring enrollment events.
• Works closely with Ohio Medicaid, county Job & Family Service agencies, public health organizations,hospitalsand community outreachstaffas necessary.
• Attends and successfully completes all required training programs,participatesin ongoing educational conference calls,webinarsand other professional development opportunities.
• Providesaccuratereports andtracking onenrollment and outreach practices for HRSA, the CEO and Board ofTrustees.
• Performs other necessary duties supported by grant funding

Qualifications:

EDUCATION

• High School graduate plus minimum of two years of college education/course completion

WORK EXPERIENCE

• Twoyearspreviousexperience working in the public sector with diverse populations,knowledgeableregardingsocial services and publichealthservices.Knowledge ofgovernment backedhealth coverage programs as well as managed care companies serving this region may be considered in lieu of college education.

Equal Employment Opportunity/Drug-Free Workplace:

The HealthCare Connection is focused on creating a community that promotes dignity and respect for employees, patients and other community members. THCC is an Equal Opportunity Employer and a Drug-Free Workplace. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, military status or other characteristics protected by law and will not be discriminated against based on disability.

THCC will only employ those who are legally authorized to work in the United States. Any offer of employment is conditioned upon the successful completion of a background check and a drug screen.