Job: Financial Eligibility Specialist

We are currently seeking a full-time Financial Eligibility Specialist. The FES is responsible for interviewing and screening applicants, researching documents, verifying information, screening for third party liability, calculating co-payment amounts, and determining eligibility for multiple County, State and Federal assistance benefits. The FES assists applicants in completing and forwarding applications for assistance and updates all systems with current information to ensure all clients receive the services they are eligible for. Responsible for aggressively monitoring the status of all applications with the multiple constituencies including government assistance agencies.

Essential Duties and Responsibilities:
1. Interview applicants for potential eligibility for multiple County, State and Federal medical assistance programs to determine residency, household composition, income, assets and medical expenses.
2. Interview clients from varied socio-economic backgrounds under crisis conditions. Determine applicants potential eligibility for State or County Medical care financial assistance.
3. Assist applicants in the completion of applications for financial and medical assistance from federal, state, and county agencies. Assist applicants in completing and forwarding applications for assistance.
4. Assist applicants with completing forms, obtain verification documentation, and refer for appropriate eligibility certification.
5. Updates all systems with the updated information to ensure all clients receive the services they are eligible for.
6. Determine applicants medical expense responsibility.
7. Aggressively monitor the status of all applications with the multiple constituencies including government assistance agencies.
8. Calculate expenses, income and assets for co-payment determination purposes.
9. Request personal documents from applicants and reviews documents to verify applicant statements.
10. With written consent, contact applicants employer, bank, insurance provider and other sources to verify gross earnings, residency, assets and medical expenses.
11. Request applicant signature for assignment of benefits when third party liability exists.
12. Research manual files and computer data files to gather or verify data needed for eligibility determination.
13. Refer ineligible applicants to other sources of medical care or social services.
14. Provide information to clients on procedures and requirements for COPE co-payment responsibilities and State and County medical assistance.
15. Participate in the agency wide Quality Management system and performance improvement activities.
16. Maintain Intake Office tracking system (database).

Minimum Qualifications:
Associates degree in a behavioral health related field or equivalent education and experience plus two (2) years experience interviewing applicants and determining eligibility for Federal, State and County financial and medical public assistance entitlement programs.
Must have reliable transportation to visit different sites.

Preferred Qualification:
Bilingual (Spanish/English)

Knowledge/Skills/Abilities:
1. Knowledge of interview techniques that encourage applicants to elicit relevant and accurate information.
2. Knowledge of resources available in the community pertinent to treatment of this population.
3. Knowledge of AHCCCS, Social Security, MEDICARE, and MEDICARE Part D.
4. Knowledge of Federal, State and County laws, statutes, regulations, and directives pertaining to public assistance programs.
5. Must have excellent communication skills, both verbal and written, with the ability to understand questions and effectively disseminate technical information to staff and clients.
6. Able to perform basic mathematics and display strong mathematical computation skills.
7. Must possess computer data entry skills or word processing skills, and able to retrieve data using various reporting formats.
8. Must possess a working knowledge of computer programs, including Microsoft Excel and Microsoft Word.
9. Able to operate common office equipment and have basic computer (word processing and spreadsheet) skills.