Eligibility Specialist - Georgetown (1.0 FTE)

Purpose:

The Eligibility Specialist supports patients in gaining access to care by enrolling uninsured individuals into insurance coverage and community resource programs for which they qualify. This role plays a critical part 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.

Health, Wellness & Retirement Benefits:     

• Medical, Dental & Vision insurance


• Paid time off & paid holidays


• Retirement with contribution match


• Life & AD&D, pet insurance


• Employee assistance program, & more!

Compensation:

• The wage range for this position is $24.48 up to $30.78.


• Final offers are individually based on various factors, including skill set, years of experience, location, qualifications, work schedule and other job-related reasons.


• Union: SEIU 1199NW

In this position you will:

• 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.

Key Skills, Knowledge, & Abilities:

• 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.

Required Qualifications:

• 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. Related work/volunteer experience may be substituted for education.

Preferred Qualifications:

• 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.

About Neighborcare Health:
Since 1968, Neighborcare Health has been removing barriers to health care for our neighbors. We believe everyone deserves a place to call their health care home, where a team of medical, dental and mental health professionals work in collaboration with each patient to develop a personal health improvement plan.

We are one of the largest providers of primary medical, dental and behavioral health care services in the Seattle area serving low-income and uninsured families and individuals, seniors on fixed incomes, immigrants, and people experiencing homelessness. Each year we care for nearly 60,000 patients at our nearly 30 non-profit medical, dental and school-based clinics. We ask everyone to pay what they can, but no one is turned away due to inability to pay.

Our clinics are located in neighborhoods where health disparities are the greatest, and our care teams, who speak over 55 languages and dialects, are as diverse as our patients. No matter who you are, or where you come from, regardless of your insurance, income or immigration status, you are welcome at Neighborcare Health.

Learn more about us here.

The full job description is available upon request.