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Texas Health Action

Eligibility Enrollment Specialist

Part-Time
$22.93/hr
Junior
Bachelor's, Associate's
Austin, TX, USA+2 moreMore locations: Texas, USA | San Antonio, TX, USA
RemoteRemote work is available only to candidates residing in Texas.
Medical, Clinical & VeterinaryClinical Support & Patient Administration

About the job

Requirements
  • A high school diploma or equivalent is required.
  • At least one year of experience in healthcare, patient services, benefits navigation, eligibility determination, enrollment, financial assistance, case management, or a related customer service role is preferred.
  • Experience reviewing and verifying eligibility documentation, including income, residency, household, and insurance information.
  • Experience working directly with patients or clients from diverse backgrounds and navigating sensitive financial or personal circumstances with professionalism and discretion.
Responsibilities
  • Conduct comprehensive eligibility screenings to identify internal and external assistance programs for which patients may qualify.
  • Verify income, residency, household composition, insurance status, and other documentation required to establish program eligibility.
  • Assist patients with enrollment and renewal for Central Health MAP and MAP Basic, including completing and submitting applications through the Central Health/VeritySource system.
  • Screen and enroll eligible patients in Texas Health Action internal assistance programs and other organizational resources designed to improve access to care.
  • Assist patients with completing applications, gathering supporting documentation, submitting required materials, and navigating enrollment systems.
  • Educate patients about available programs, eligibility requirements, benefits, required documentation, renewal timelines, and responsibilities for maintaining eligibility.
  • Help patients understand available assistance options and determine which programs best meet their healthcare and financial needs.
  • Track pending applications, referrals, eligibility determinations, approvals, denials, and renewals through completion.
  • Proactively follow up with patients to obtain missing information or documentation and help prevent delays or interruptions in assistance.
  • Assist patients with resolving enrollment barriers, including incomplete applications, documentation issues, eligibility questions, requests for additional information, and denials.
  • Maintain accurate and timely documentation of screenings, applications, referrals, enrollment outcomes, and patient interactions in approved electronic systems.
  • Coordinate with clinic teams, Patient Support Services, and other departments to facilitate access to care following enrollment or approval.
  • Maintain current knowledge of internal and external assistance programs, including eligibility criteria, benefits, application procedures, documentation requirements, and renewal processes.
  • Maintain familiarity with community resources that address barriers to healthcare and other supportive service needs.
  • Provide patient-centered and culturally responsive assistance while helping individuals navigate complex eligibility and enrollment processes.
  • Maintain compliance with HIPAA, organizational privacy and confidentiality standards, program requirements, and applicable regulations.
  • Identify recurring eligibility and enrollment barriers and communicate trends and resource gaps to Patient Support Services leadership.
  • Perform other eligibility determination, enrollment, patient assistance, benefits navigation, and resource coordination duties as assigned.
Desired Qualifications
  • An associate or bachelor's degree in healthcare, social services, public health, human services, or a related field is preferred.
  • Experience assisting individuals with applications for healthcare coverage, financial assistance, public benefits, medication assistance, or community-based programs is preferred.
  • Bilingual English/Spanish skills are preferred.

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