Eligibility Specialist I
About The Position
The Eligibility Specialist I works for the Maine Department of Health and Human Services, helping Maine residents access health coverage through MaineCare. The position evaluates information and applies program standards to determine eligibility and benefits accurately. It uses multiple technology systems to enter, review, and verify eligibility information and documentation, and explains program rules, requirements, and decisions to applicants and members in writing and by phone. The specialist also reviews information submitted electronically or by mail for completeness and compliance and connects people with other programs and services that may support their health and well-being. The work is fast-paced, collaborative, and mission-driven, with a strong emphasis on customer service, problem-solving, teamwork, and communication with people from diverse backgrounds.
Requirements
- Two years of combined training, education, and/or experience in a health or human services setting demonstrating competency in applying policies and rules to make decisions, maintaining and verifying digital records, and/or responding to client requests.
- Strong communication and interpersonal skills.
Responsibilities
- Evaluate information and apply program standards to determine MaineCare eligibility and benefits accurately.
- Use multiple technology systems to enter, review, and verify eligibility-related data and documentation.
- Explain MaineCare rules, requirements, and decisions clearly to applicants and members 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 and at least three weeks of annual vacation leave, with vacation accrual increasing with years of service.
- Personal leave for overtime-exempt employees.
- 12 days of sick leave per year.
- State payment of 85%–95% of employee-only health insurance premiums, depending on salary.
- A 5% employee-only health insurance premium credit for eligible participation.
- State payment of 100% of employee-only dental insurance premiums.
- Retirement contributions equivalent to 14.06% of employee pay to MainePERS.
- Gym membership reimbursement of up to $40 per month.
- Health and dependent care flexible spending accounts.
- Eligibility for Public Service Student Loan Forgiveness.
- Employee assistance through the Living Resources Program.
- Six weeks of fully paid parental leave for employees welcoming a child, including non-birthing and adoptive parents; additional unpaid leave may be available under the Family and Medical Leave Act.
- Voluntary deferred compensation through a MaineSaves 457(b) account.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
