Eligibility Specialist - Georgetown (1.0 FTE)

Neighborcare Health Career•Seattle, WA

2d•Hybrid

About The Position

The Eligibility Specialist supports patients in gaining access to care by enrolling uninsured individuals into insurance coverage and community resource programs for which they may qualify. This role is critical in reducing financial barriers by maximizing enrollment into programs where Neighborcare Health is a participating provider. The Eligibility Specialist is responsible for verifying and documenting patient household size and income, determining eligibility for financial assistance, and accurately placing patients on the sliding fee discount scale when appropriate. Working in close partnership with clinical, billing, and care team staff, the Eligibility Specialist shares accountability for advancing Neighborcare Health’s mission, upholding guiding principles, and meeting organizational goals that promote equitable access to care.

Requirements

Obtain and complete WAHBE’s comprehensive training program and pass a certification exam within 3 months of employment
Maintain certification by completing all required quarterly trainings, evaluations, and continuing education.
Stay current on public insurance programs, benefits, and eligibility requirements by actively participating in on-site and off-site trainings, meetings, and ongoing learning opportunities.
Current Driver’s License and up-to-date car insurance
High school diploma or equivalent.
Strong communication skills with the ability to actively listen and respond to patients and staff in a timely, professional, and respectful manner, both verbally and non-verbally.
Proficiency in using computers and a variety of software applications (including electronic health records and data systems).
Ability to read, write, and communicate effectively in English, with basic math skills required for eligibility and income calculations.
Ability to work independently with a high level of initiative, organization, and self-motivation.
Demonstrated reliability, including consistent, punctual attendance.
Ability to travel between clinic sites as needed and adapt quickly to different work environments.
Ability to manage a high volume of work in a fast-paced environment while maintaining accuracy, attention to detail, and professionalism.
Ability to handle sensitive, confidential information in compliance with HIPAA and all Neighborcare Health policies and procedures.

Nice To Haves

Experience working with Washington State programs, including the Health Care Authority (HCA), the Department of Social and Health Services (DSHS), Healthplanfinder (HPF), and other eligibility or financial assistance programs.
Knowledge of patient registration, scheduling systems, and general administrative workflows within a healthcare setting.
Familiarity with Medicaid and other publicly sponsored insurance programs, including enrollment and renewal processes.
Bilingual or multilingual skills, with the ability to communicate effectively with diverse patient populations.
Flexibility and adaptability, with the ability to travel between clinic sites and provide coverage across locations on a daily or weekly basis.

Responsibilities

Conduct in-depth interviews with patients to assess eligibility for insurance programs and the Neighborcare Health sliding fee discount program.
Clearly explain program rules, rights, and responsibilities in plain, supportive language.
Gather, verify, and document eligibility information, including residency, citizenship, household size, income, and other financial resources.
Support patients in obtaining required documentation, resolving discrepancies, and completing applications.
Determine initial and renewal eligibility for publicly sponsored programs in accordance with established policies and procedures.
Perform accurate data entry and research guidelines to resolve eligibility questions.
Maintain working knowledge of health insurance programs and eligibility requirements by attending training and staying current on policy updates.
Communicate coverage options to patients in a clear and accessible way.
Partner with Front Desk, Patient Contract Center, and Insurance Coordination Team to identify uninsured or underinsured patients and proactively connect them to eligibility services.
Support insured patients with renewals, plan updates, and changes to ensure continued coverage and alignment with Neighborcare providers.