Eligibility & Enrollment Associate

Overview

Under general supervision, provides outreach and application assistance to individuals applying for Federal, State and Local programs and resolves simple problems and complaints.

Responsibilities

Essential Duties :

• Interview / screen applicants in-person or over the phone in a professional and courteous manner to obtain appropriate demographic and household information needed to determine their eligibility for MAP / MAP BASIC, Medicaid, or CHIP.
• Assist clients in-person or over the phone with completing an application for MAP, Medicaid or CHIP and submitting the documents required to apply.

If requested, assist the client submitting additional documents to complete the application process.

• Paying attention to details, accurately enter data and scan / upload required documents in the appropriate database.
• Applying Central Health policies, reviews and determines MAP eligibility for individuals experiencing homelessness and applicants submitting renewal attestations.
• Assist MAP / MAP BASIC applicants in-person at the eligibility offices with scheduling eligibility appointments and resolving simple problems and complaints.
• Troubleshoot and / or conduct follow-up with various agencies, including the Texas Health and Human Services Commission and CHIP Provider Line, on behalf of the applicant.
• Performs other duties as assigned.

Knowledge / Skills / Abilities :

Knowledge of : Federal, State, and local healthcare programs such as MAP, Medicaid, CHIP and the Health Insurance Marketplace.

Customer Service and interviewing principals, techniques and proper etiquette.

Skill in : Determining what needs to be recorded and accurately and completely recording information to meet all policy, procedure and regulatory requirements.

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.Being aware of others' reactions and understanding why they react the way they do.

Performing basic operations in Microsoft Office Suite.Managing one’s own time.Actively looking for ways to help people and establishing and maintaining effective working relationships.

Ability to : Work effectively with individuals from diverse backgrounds.Problem solve and use deductive reasoning to apply general rules to specific.

problems and come up with logical answers.Multitask-shift between activities as needed.Pay attention to details.Read and understand basic Spanish on documents and forms.

Make fast, simple, repeated movements of the fingers, hands, and wrists.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.

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

The employee frequently is required to : Reach, walk.The employee occasionally is required to : Lift up to 25 pounds, drive a vehicle.

Qualifications

EDUCATION :

• High school diploma or equivalent required .
• Bachelor's degree preferred.

EXPERIENCE :

• 2 years’ relevant experience required .
• Ability to speak and read Spanish preferred.
• Experience determining eligibility for Federal, State or local programs preferred.

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