Eligibility Specialist I

State of Maine•Skowhegan, ME

17h•Hybrid

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.

Requirements

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.

Nice To Haves

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.

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

13 paid holidays
3+ weeks of vacation leave annually
12 days of sick leave per year
Health Insurance Coverage – The State of Maine pays 85%-95% of employee-only premiums
Health Insurance Premium Credit
Dental Insurance – The State of Maine pays 100% of employee-only dental premiums
Retirement Plan – The State contributes the equivalent of 14.06% of the employee's pay towards the Maine Public Employees Retirement System (MainePERS), on behalf of the employee.
Gym Membership Reimbursement – up to $40 per month
Health and Dependent Care Flexible Spending Accounts
Public Service Student Loan Forgiveness
Living Resources Program – employee assistance program
Parental leave – six weeks of fully paid parental leave for all employees who are welcoming a child—including non-birthing and adoptive parents
Voluntary Deferred Compensation – MaineSaves 457(b) account