Eligibility Specialist I
About The Position
As an Eligibility Specialist I, you’ll play a vital role in connecting Maine residents to the health coverage they need through MaineCare—the state’s largest health insurance program serving lower-income adults, children, older adults, and people with disabilities. In this position, you’ll help people navigate important life situations while ensuring accuracy in determining eligibility. The work is fast-paced, collaborative, and mission-driven with a strong focus on customer service, problem solving, and teamwork. Strong communication and interpersonal skills are essential as you’ll work with people from diverse backgrounds, with varying needs, and help them navigate complex systems during moments that matter.
Requirements
- To qualify for this position, you must have a two (2) year combination of training, education, and/or experience in a health or human services setting which demonstrates competency in applying policies and rules to make decisions, maintaining and verifying digital records, and/or responding to client requests.
Responsibilities
- Evaluate information and apply program standards to accurately determine MaineCare eligibility and benefits.
- Use multiple technology systems to enter, review, and verify eligibility-related data and documentation.
- Clearly explain MaineCare rules, requirements, and decisions to applicants and members—both in writing and over the phone.
- Review and process information received electronically or by mail to ensure completeness and compliance.
- Connect individuals with additional programs and services that may support their health and well-being.
Benefits
- Work-Life Fit – Rest is essential. Take time for yourself using 13 paid holidays, 12 days of sick leave, and 3+ weeks of vacation leave annually. Vacation leave accrual increases with years of service, and overtime-exempt employees receive personal leave.
- Health Insurance Coverage – The State of Maine pays 85%-100% of employee-only premiums ($12,845.82 - $15,112.76 annual value), depending on salary. Use this chart to find the premium costs for you and your family, including the percentage of dependent coverage paid by the State.
- Health Insurance Premium Credit – Participation decreases employee-only premiums by 5%. Visit the Office of Employee Health and Wellness for more information about program requirements.
- Dental Insurance – The State of Maine pays 100% of employee-only dental premiums ($395.72 annual value).
- Retirement Plan – The State contributes the equivalent of 14.11% of the employee's pay towards the Maine Public Employees Retirement System (MainePERS).
- Parental leave is one of the most important benefits for any working parent. All employees who are welcoming a child—including non-birthing and adoptive parents—receive six weeks of fully paid parental leave. Additional, unpaid leave may also be available, under the Family and Medical Leave Act.
- State employees are eligible for an extensive and highly competitive benefits package, covering many aspects of wellness. Learn about additional wellness benefits for State employees from the Office of Employee Health and Wellness.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
