Eligibility Screening Services
Eligibility Screening Specialist
,
Full Time
Job Summary
An Eligibility Screening Specialist is a representative of the ESS Corporate office that provides temporary coverage for absences or vacancies in the role of On-Site representative, as well as serves as training support for common workflow task if needed. Duties will include assisting with inventory review, inventory backlog, special projects, and auditing processes, procedures and workflow. They will also be responsible for making recommendations to Eligibility Screening Services Leadership based on findings, as well as training and mentoring Eligibility Screening Services staff performing routine tasks as well as special projects.
Essential Functions
An Eligibility Screening Specialist is a representative of the ESS Corporate office that provides temporary coverage for absences or vacancies in the role of On-Site representative, as well as serves as training support for common workflow task if needed. Duties will include assisting with inventory review, inventory backlog, special projects, and auditing processes, procedures and workflow. They will also be responsible for making recommendations to Eligibility Screening Services Leadership based on findings, as well as training and mentoring Eligibility Screening Services staff performing routine tasks as well as special projects.
Essential Functions
- Reviews and analyzes applications and supporting documentation to determine eligibility for specific programs, benefits, or services (e.g., healthcare, public assistance, housing, etc.).
- Accurately inputs and maintains data related to applicants' eligibility status into databases or management systems, ensuring compliance with data protection and privacy standards.
- Examines and verifies the authenticity and completeness of submitted documentation, including income verification, identification, and other relevant forms.
- Communicates with applicants to obtain additional information, clarify discrepancies, and provide updates regarding the status of their eligibility applications.
- Responds to inquiries from applicants, stakeholders, and internal teams, providing clear and professional explanations of eligibility criteria and application procedures.
- Ensures all eligibility determinations comply with applicable laws, regulations, and policies. Prepare and submit regular reports regarding eligibility status, trends, and outcomes.
- Identifies and resolves issues related to eligibility determinations, including inconsistencies or discrepancies in application materials, and escalate issues when necessary.
- Stays updated on relevant laws, policies, and best practices related to eligibility screening, and recommend process improvements to increase efficiency and accuracy.
- Works with cross-functional teams, including program managers, caseworkers, and other specialists, to ensure seamless service delivery and accurate Participates in training sessions to enhance knowledge of eligibility requirements and improve job performance. May assist in training new staff or providing guidance on complex cases.
- 75% travel position. The position requires this individual to be able to travel as needed to remote facilities located across the United States, involving driving, flying, renting car, and staying overnight in a hotel. The individual must be capable of managing travel expenses for 30 days at a time, while awaiting expense report reimbursement.
- Performs other duties as assigned.
- Complies with all policies and standards.
- H.S. Diploma or GED required
- Bachelor's Degree in social services, healthcare administration, public policy, or a related field preferred
- 2-4 years of experience in eligibility screening, case management, customer service, or a related field required
- Strong attention to detail and accuracy in data entry and documentation review.
- Excellent communication skills, both written and verbal, with the ability to clearly explain eligibility processes and requirements.
- Ability to handle sensitive and confidential information with discretion.
- Strong analytical and problem-solving skills.
- Proficiency with office software (e.g., Microsoft Office Suite) and eligibility management systems.
- Ability to manage a high volume of applications and meet deadlines.
- Excellent organizational and time-management skills.
- Working knowledge of Medicare, Medicaid, Medicaid for Nursing Home Placement, Crime Victims, Vocational Rehabilitation, QMB, SSI and any/all other third party coverage and other available local, state and federal programs preferred.