• Eligibility Specialist

    Req No.
    Central Health
    Job Locations
    US-TX-Austin | US-TX-Austin
    Regular Part-Time
  • Overview

    Under general supervision, refers, enrolls and/or assists customers in obtaining appropriate healthcare, and assists customers in resolving complex problems and complaints.


    Makes decisions for multiple programs regarding a client’s eligibility for healthcare services including interpreting and applying complex program requirements.


    Explains program benefits and how to access services.


    Assists customers in resolving complicated problems and complaints regarding services.


    Applies performance standards to determine the accuracy of simple to complex program decisions.


    Performs other duties as assigned.


    Knowledge of:

    • Administrative and clerical procedures and systems such as word processing and data base systems,  and other office procedures and terminology
    • Interviewing techniques and proper interviewing etiquette
    • Conflict resolution techniques

    Skill in:

    • Determining what needs to be recorded and accurately and completely recording information to meet all policy, procedure and regulatory requirements
    • Using relevant information and individual judgment to determine whether events or processes comply with laws, regulations, or standards
    • Analyzing information and evaluating results to choose the best solution
    • Knowing how to find information and identifying essential information
    • Communicating effectively in speaking and writing as indicated by the needs of the audience
    • Coordinating activities by adjusting actions in relation to others' actions
    • Fluently communicating verbally in English/Spanish
    • Being aware of others' reactions and understanding why they react the way they do
    • Performing basic operations in Microsoft Office Suite
    • Listening to what other people are saying and asking questions as appropriate
    • Actively looking for ways to help people and establishing and maintaining effective working relationships

    Ability to:

    • Efficiently shift back and forth between two or more activities or sources of information
    • Correctly follow a given rule or set of rules in order to arrange things or actions in a certain order including procedures, orders or logical operations
    • Use deductive reasoning to apply general rules to specific problems to come up with logical answers and decide if an answer makes sense
    • Add, subtract, multiply or divide quickly and correctly and to understand and organize a problem and then to select a mathematical method or formula to solve the problem
    • Communicate information and ideas in speaking and writing so others will understand
    • Pay attention to details
    • Work effectively with individuals from diverse backgrounds
    • Read and understand basic Spanish on documents and forms
    • See details of objects at a close range (within a few feet of the observer)
    • Make fast, simple, repeated movements of the fingers, hands, and wrists

    Present information in a clear concise manner

    Evaluate various situations and decide on an appropriate course of action


    Physical Abilities:

    While performing the duties of this job, the employee constantly is required to:  Grasp, handle, feel, see, sit, listen, talk


    The employee frequently is required to:  Reach


    The employee occasionally is required to:  Lift up to 10 pounds, drive a vehicle



    Minimum of 60 hours from an accredited college plus four years of related experience. 


    Any equivalent combination of education and experience may substitute.


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