Eligibility Specialist
The HealthCare Connection (THCC), founded in 1967, 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 a Level 3 Patient Centered Medical Home (PCMH) and operates two primary care locations and six school-based health centers, serving over 20,000 patients with services in Primary Care, Infectious Disease, Substance Use, Integrated Behavioral Health, Dental Services, Women’s Health, and Pharmacy.
About the role
The Eligibility Specialist provides enrollment assistance and health coverage education to patients and community members. 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.
Responsibilities
- Provides enrollment assistance for uninsured adults and children to access subsidized, low-cost, and free health insurance programs through the Health Insurance Marketplace and benefits.gov for Medicaid.
- Provides structured healthcare outreach and education to patients on A.C.A.-related coverage options and obligations.
- Distributes outreach materials to patients, community members, partner organizations, and businesses to build coverage awareness as dictated by the Outreach Plan.
- Attends community events to promote coverage availability, coverage options, and enrollment.
- Collaborates with local organizations to build awareness of coverage options, share best practices, and assist during enrollment events.
- Works closely with Ohio Medicaid, county Job & Family Service agencies, public health organizations, hospitals, and community outreach staff as necessary.
- Attends and successfully completes all required training programs, participates in ongoing educational conference calls, webinars, and other professional development opportunities.
- Provides accurate reports and tracking on enrollment and outreach practices for HRSA, the CEO, and Board of Trustees.
- Travels between health center sites to maximize patient enrollment and education.
- Performs other necessary duties supported by grant funding.
Requirements
- High school graduate plus a minimum of two years of college education/course completion.
- Two years of previous experience working in the public sector with diverse populations, knowledgeable regarding social services and public health services.
- Knowledge of government-backed health coverage programs as well as managed care companies serving this region may be considered in lieu of college education.
Benefits
- Health Insurance and Rewards Program
- Dental and Vision Insurance
- Free Life & Short-Term Disability Insurance
- 403(b) Retirement Plan with employer match
- Comprehensive Paid Time Off (PTO)
- 10 Paid Holidays