Eligibility Specialist I

Department of Health and Human Services • Wilton, CT

4d • 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.
• 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
• 12 days of sick leave
• 3+ weeks of vacation leave annually
• Health Insurance Coverage
• Dental Insurance
• Six weeks of fully paid parental leave
• Additional, unpaid leave may also be available, under the Family and Medical Leave Act

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree