Eligibility Enrollment Specialist

Schedule: MondayFriday, during clinic hours, or part-time as needed. This position provides direct patient support to reduce financial, administrative, and access-related barriers to care. The Eligibility Enrollment Specialist conducts eligibility screenings, verifies required documentation, educates patients about available programs, completes and submits applications, coordinates referrals, and follows applications through determination and renewal. Programs may include Central Health's Medical Access Program (MAP) and MAP Basic, Texas Health Action assistance programs, medication and pharmaceutical assistance programs, healthcare coverage resources, and other local, state, federal, nonprofit, or community-based programs for which patients may qualify. This position is available in Austin (Central and South locations), San Antonio, and remotely for candidates residing in Texas.

Core Functions: Conduct comprehensive eligibility screenings to identify internal and external assistance programs for which patients may qualify. Verify income, residency, household composition, insurance status, and other documentation required to establish program eligibility. Assist patients with enrollment and renewal for Central Health MAP and MAP Basic, including completing and submitting applications through the Central Health/VeritySource system. Screen and enroll eligible patients in Texas Health Action internal assistance programs and other organizational resources designed to improve access to care. Assist patients with completing applications, gathering supporting documentation, submitting required materials, and navigating enrollment systems. Educate patients about available programs, eligibility requirements, benefits, required documentation, renewal timelines, and responsibilities for maintaining eligibility. Help patients understand their available assistance options and determine which programs best meet their healthcare and financial needs. Track pending applications, referrals, eligibility determinations, approvals, denials, and renewals through completion. Proactively follow up with patients to obtain missing information or documentation and help prevent delays or interruptions in assistance. Assist patients with resolving enrollment barriers, including incomplete applications, documentation issues, eligibility questions, requests for additional information, and denials. Maintain accurate and timely documentation of screenings, applications, referrals, enrollment outcomes, and patient interactions in approved electronic systems. Coordinate with clinic teams, Patient Support Services and other departments to facilitate access to care following enrollment or approval. Maintain current knowledge of internal and external assistance programs, including eligibility criteria, benefits, application procedures, documentation requirements, and renewal processes. Maintain familiarity with community resources that address barriers to healthcare and other supportive service needs. Provide patient-centered and culturally responsive assistance while helping individuals navigate complex eligibility and enrollment processes. Maintain compliance with HIPAA, organizational privacy and confidentiality standards, program requirements, and applicable regulations. Identify recurring eligibility and enrollment barriers and communicate trends and resource gaps to Patient Support Services leadership. Perform other eligibility determination, enrollment, patient assistance, benefits navigation, and resource coordination duties as assigned.

Compensation: Based on the position's duties and requirements, this role has a starting hourly rate of $22.93. The initial hourly rate will be determined by the selected candidate's qualifications and relevant experience.