Eligibility and Financial Screening Associate

Overview

Under general supervision, this role supports individuals applying for local, state, and federally funded healthcare programs and grant programs by providing outreach, application assistance, and resolving routine inquiries or concerns. This position is responsible for the accurate and timely upload of client documentation into eligibility portals to support access to grant programs and enrollment processes. This role works closely with Eligibility and Enrollment Specialists to confirm that clients meet program requirements, maintaining detailed records and adhering strictly to all regulatory guidelines. This position requires strong attention to detail, excellent communication skills, and a commitment to providing high-quality support to clients throughout the eligibility process.

Responsibilities

Essential Functions

• Interview and screen applicants in person or by phone to collect demographic, household, and financial information required to determine eligibility for healthcare programs such as MAP, MAP BASIC, Medicaid, CHIP, and grant-funded services (e.g., Ryan White & ADAP).
• Assist clients with completing and submitting applications and required documentation, including renewals and follow-up submissions, ensuring accuracy and compliance with program guidelines.
•  Collect, review, and upload client eligibility documents (e.g., proof of income, residency, HIV status, and insurance status) into designated eligibility portals, including VeritySource, Take Charge Texas, Provide Enterprise, and other systems as required. Process standard application, including Point of Service and Attestations.
•  Monitor timelines and renewal dates to prevent lapses in eligibility and maintain continuous access to services; coordinate with Eligibility and Enrollment Specialists and Operations Teams to resolve missing or expiring documentation.
• Maintain organized and accurate client records and data in approved databases and software systems, ensuring strict confidentiality and data integrity.
•  Provide general assistance to clients visiting eligibility offices, including helping schedule appointments, addressing questions, resolving simple issues or complaints, and making appropriate service referrals.
• Troubleshoot and follow up with external agencies such as the Texas Health and Human Services Commission and CHIP Provider Line on behalf of applicants to support application completion and status resolution.
• Attend required training and updates related to eligibility programs, documentation standards, and policy changes to maintain up-to-date knowledge of program requirements.
•  Supports the creation and update of client profiles by completing intake registrations in funder databases as patients enter or re-enter HIV care
• Supports audit and quality assurance processes by participating in periodic reviews of client files and eligibility determinations.
• Attend community events and represent the organization as needed, including evenings and weekends.
• Perform general office duties, including picking up and distributing mail from the post office.
• Uphold organization's values by consistently demonstrating professionalism in all actions, job performance, personal conduct, and communications.
•  Perform other related duties as assigned.

Knowledge, Skills and Abilities:

• Proficient in data entry, research, information retrieval, and use of EMR, Microsoft Office Suite, Excel, and Adobe Pro.
• Strong ability to deliver professional, client-centered customer service with empathy, clarity, and efficiency.
• Bilingual (English/Spanish) highly preferred.
• Exceptional attention to detail with the ability to accurately review, enter, and manage information across various systems and processes.
• Knowledge of financial eligibility processes, regulatory standards, and specialty grants (Ryan White,Title V, PHC, Family Planning).
• Ability to work effectively with diverse populations and adjust actions based on client needs.
• Knowledge of federal, state, and local healthcare programs, such as MAP, Medicaid, CHIP, ADAP and the Health Insurance Marketplace

Qualifications

Minimum Education:

• High School Diploma or equivalent (higher degree accepted)

Minimum Experience: 

• 2 years Experience in document management or service coordination, preferably in a health or social service setting.