What are the responsibilities and job description for the Eligibility Specialist position at Spring Branch Community Health Center?
- Bilingual – Spanish and English required for this role!
The Eligibility Specialist plays a vital role in helping patients navigate healthcare coverage options. This includes determining eligibility for sliding fee discounts, verifying coverage, and assisting with enrollment in various programs and third-party payors. The specialist reviews financial documents, supports patients in completing applications, and ensures they receive the guidance needed to access care. Once eligibility is confirmed, the specialist also coordinates provider appointments to facilitate timely access to services.
Qualifications
- High School Diploma or GED required
- Bilingual in English and Spanish required
- Minimum of 3 years of customer service experience
- Familiarity with insurance eligibility verification and coverage benefits
- Knowledge of medical terminology (preferred)
- Proficiency in Microsoft Word and Excel
- Strong interpersonal and communication skills
- Community Health Worker Certification required (or obtained within the first year of employment)
- Current BLS or equivalent certification required
- Review financial information to determine eligibility for healthcare programs and sliding fee discounts
- Verify insurance coverage and clearly communicate benefits to patients
- Assist with ACA Marketplace enrollments (once certified as a Certified Application Counselor)
- Guide patients through the application processes and ensure all required documentation is collected
- Input patient demographic, financial eligibility data and third-party details into the EMR system
- Educate patients on SBCHC services and clinic policies
- Timely follow up on pending applications and payment vouchers
- Attend company-wide and departmental meetings and trainings
- All staff are expected to participate in safety initiatives and emergency response activities
- Perform additional duties as assigned
- Collaborate effectively with teammates and other departments to ensure seamless patient support
- Demonstrate flexibility and a cooperative attitude in a fast-paced, team-oriented environment
- Actively participate in team meetings and contribute to problem-solving and process improvement initiatives
- Support colleagues by sharing knowledge, offering assistance, and maintaining open communication
- Promote a positive and respectful workplace culture through professionalism and mutual support
- Paid Time Off
- 10 Company holidays
- 1- 8-hour Personal holiday
- 401(k) retirement plan
- Bereavement Leave
- Continuing Education
- Employee Assistance Plan
- Student Loan Forgiveness-if applicable
- Medical, Dental, Vision – Aetna
- Basic Life ($35k)/AD&D – 100% paid for by the employer
- Employee Assistance Plan (EAP) – 100% paid for by the employer
- Additional benefits available at employee expense:
- Additional Voluntary Life Insurance
- Short-Term Disability (STD)
- Long-Term Disability (LTD)
- Accident Insurance
- Critical Illness Insurance
- Hospital
Salary : $35,000