Remote Eligibility & Benefits Navigator

Texas Health Action; United States; Remote; USD 26,000 - 37,000; Full time

Job summary

Texas Health Action seeks an Eligibility Enrollment Specialist to identify and enroll patients in internal and external assistance programs, including Central Health MAP and MAP Basic. The role supports enrollment through Central Health/VeritySource and coordinates referrals to improve access to care.

This fixed 6-month, 1099 independent contractor position offers scheduling Monday–Friday during clinic hours, with remote options for Texas residents.

Qualifications

• 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 1 year of experience in healthcare, patient services, benefits navigation, eligibility determination, enrollment, financial assistance, case management, or related customer service role preferred.
• Experience assisting individuals with applications for healthcare coverage, financial assistance, public benefits, medication assistance, or community-based programs preferred.

Responsibilities

• 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.

Skills

Bilingual English/Spanish

Education

High school diploma or equivalent

Associate or Bachelor's degree in healthcare or related field (preferred)

Job description

Texas Health Action seeks an Eligibility Enrollment Specialist to identify and enroll patients in internal and external assistance programs, including Central Health MAP and MAP Basic. The role supports enrollment through Central Health/VeritySource and coordinates referrals to improve access to care.

This fixed 6-month, 1099 independent contractor position offers scheduling Monday–Friday during clinic hours, with remote options for Texas residents.