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Eligibility Specialist - $24.04
Eligibility Specialist - $24.04Access To Healthcare Network • Las Vegas, NV, USA
Eligibility Specialist - $24.04

Eligibility Specialist - $24.04

Access To Healthcare Network • Las Vegas, NV, USA
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WINNER- 1st PLACE, 2nd YEAR IN A ROW

2021 BEST PLACES TO WORK IN NORTHERN NEVADA!

2025 BEST PLACES TO WORK IN NEVADA FOR WORKING PARENTS!

Check out our AWESOME Benefits!

4 weeks Paid Time Off in the First Year

Medical, Dental, and Vision benefits - effective 1st DAY OF THE MONTH, following date of hire

Free Health Insurance Options for Full Time Employees

Low Cost Health Insurance Options for Dependents

Health Savings Account

403(b) account with matching

Free Life Insurance ($50k) & Long Term Disability

14 paid holidays annually

Tuition assistance

Continuing Education Support

Additional Perks and Discounts

Job Purpose :

The Eligibility Specialist will assist in improving the health outcomes for clients living with HIV / AIDS, providing eligibility determination services, and assisting clients to obtain access to other public and private programs by enrolling into Ryan White and determine payer source for Aids Drugs Administration Program (ADAP) services.

Abide by all HIPAA requirements.

Client Interaction : Determine eligibility screening requirements for potential Ryan White services to ensure clients are eligible for assistance and prescreen clients for the HIP program. Assist clients with medication and treatment to achieve viral suppression. Assist clients in filling out the Ryan White Liberty Dental Application for enrollment for all eligible clients. Refer clients to case management for core medical and supportive services.

Community Partner Interaction : Develop and maintain effective working relationships with AHN providers, members, program partners and program funders. Ability to be compassionate and professional with staff and partner agencies.

Database Management : Assist with scheduling appointments, maintaining spreadsheets, tracking payer sources for ADAP services. Complete CAREWare, and RWISE data entry and application uploads for all eligibility applications. Complete data entry in pharmacy benefit manager for ADAP services.

Insurance Assistance : Preferred experience with Medicaid, Medicare Part A & B, Nevada Check-Up, and Prescription Drug Programs.

Payment Processing : Assist with Health Insurance Premiums, co-pays or deductibles, tax program, etc.

  • Required to pass a background check through the State of
  • Subject to Medicare / Medicaid fraud background
  • Required to obtain a Community Health Worker course Certification within the first year of employment at the agency's expense.
  • Must be able to obtain an Exchange Enrollment Facilitator License (EEF) at the agency's

QUALIFICATIONS :

  • Minimum Education : High School Diploma; AA Degree Preferred.
  • Required to obtain a Community Health Worker Certification within the first year of employment at the agency's expense.
  • Must be able to obtain an Exchange Enrollment Facilitator License (EEF) within 90 days at the agency's expense.
  • One (1) year working in health care related social work.
  • Two years' (2) experience working with databases and Microsoft office.
  • Preferred but not required experience working with CAREWare, and Salesforce.
  • Physical Requirements :

  • Must be able to lift, carry up to 30 pounds with a fair consistency.
  • The noise level in the work environment is usually moderate and the employee usually works in a climate-controlled office environment.
  • Be able to sit at a computer for 6 - 8 hours per day.
  • Be able to stand between 3 - 6 hours per day.
  • Be able to withstand hand / wrist deviation and repetition.
  • W ORK E NVIRONMENT

  • The noise level in the work environment is usually moderate and the employee usually works in a climate-controlled office
  • The statements herein are intended to describe the general nature and level of the position, but are not necessarily a complete list of responsibilities, duties and skills required of employee(s) so classified. As such, responsibilities, duties, and required skills may be changed, expanded, reduced, or deleted to meet the business needs of Access to Healthcare Network. Furthermore, they do not establish a contract or implied contract for employment.
  • As an equal opportunity employer, we are committed to identifying and developing the skills and leadership of people from diverse backgrounds. We encourage all qualified candidates to apply.

    Required to pass a background check through the State of Nevada

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    Eligibility Specialist • Las Vegas, NV, USA

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