Eligibility Specialist - Credentialed
About The Position
Easterseals MORC is hiring a Credentialed Eligibility Specialist to help individuals receiving behavioral health services navigate applications, renewals, and follow-up for Medicaid, the Healthy Michigan Plan, Social Security benefits, patient assistance programs, and other available entitlements. The Specialist monitors benefit status, helps gather financial and supporting documentation, coordinates with care teams and public agencies, and serves as a resource for navigating complex eligibility systems. The position proactively works to prevent procedural disenrollment, restore coverage when gaps occur, and help ensure Easterseals MORC remains the payer of last resort.
Requirements
- Bachelor’s degree from an accredited college or university with a major in Psychology, Social Work, Human Services, Healthcare Administration, Public Health, or a related area.
- At least one year of full-time experience in behavioral health, case management, Medicaid eligibility, benefits navigation, healthcare access, revenue cycle, or a related human services role.
- Valid Michigan driver's license and current auto insurance.
Nice To Haves
- Experience completing or supporting Medicaid, Healthy Michigan Plan, SSI/SSDI, or other public-benefit applications.
- QMHP or QIDP certification.
- SOAR Training.
Responsibilities
- Meet with individuals to assist with applications and renewals for the Healthy Michigan Plan, Medicaid, Social Security SSI/SSDI, patient assistance programs, and other applicable benefits.
- Coordinate eligibility support at intake and throughout services to confirm that appropriate benefits have been initiated, secured, and maintained.
- Monitor ongoing benefits and coverage status to support continuity of care and ensure Easterseals MORC remains the payer of last resort.
- Gather and review financial, identity, residency, disability, and other supporting documentation required for applications and renewals.
- Explain eligibility notices, renewal requirements, verification requests, deadlines, and next steps in a clear and understandable manner.
- Track applications, renewals, pending verifications, denials, closures, and reinstatement activity in designated systems and reports.
- Identify individuals at risk of procedural disenrollment or loss of coverage and take timely follow-up action.
- Assist with reapplication, reconsideration, reinstatement, or referral for appeal support when coverage is denied or terminated.
Benefits
- Low-cost dental, health, and vision insurance
- Dependent care reimbursement
- Up to 5 days of paid FMLA for maternity, paternity, foster care, and adoption
- Generous 401(k) retirement plan
- Paid leave options
- Up to $125 bonus for taking 5 days off in a row
- 10 paid holidays and 3 floating holidays
- Wellness programs
- Public Service Loan Forgiveness (PSLF) employer
- Bonuses and extra incentives to reward hard work and dedication
- Mileage reimbursement in accordance with the IRS rate
- Free financial planning services through partnerships with the LoVasco Consulting Group and SoFi
- Student loan repayment options
- Pet insurance
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
