Benefit Eligibility Specialist Jobs in Texas

2 years previous experience working at or with an HMO or MCO organization required

A bachelor's degree may substitute for the years of required work experience

Being fully vaccinated against COVID-19 is required for all employees unless approved for a medical or religious exemption

High school diploma or GED required

Manually update member eligibility data in the claims processing system using multiple sources for reference, including applications, databases, and reports

Research and resolve member eligibility issues thoroughly, timely, and accurately

Desirable Knowledge, Skills, and Abilities

Sherburne County offers a comprehensive benefits package, including:

Knowledge of Federal and State structure, rules and policies governing Income Maintenance Programs.

Performs job responsibilities in a manner consistent with the County's vision, mission, and values.

Informs immediate supervisor of all-important matters pertaining to assigned job responsibilities.

The primary responsibilities for this position will be performed approximately 100% of the time indoors.

Computer Skills (CLIK) – A basic computer literacy test, assessing knowledge of internet browsers, email, chat, and word processing.

Basic Competency (CBST) – A test of basic math, verbal, and communication skills, designed to assess job readiness and trainability.

If you experience problems applying online, please call the People First Service Center at (877) 562-7287.

Benefits of Working for the State of Florida:

For a more complete list of benefits, visit www.mybenefits.myflorida.com.

Interviewing applicants to obtain and verify information needed to determine eligibility for Food Assistance, Medicaid, and Cash Assistance.

Qualifications - Education and Experience

Meet the needs of consumers, follow through, meeting deadlines, and maintain skills and knowledge to perform the job.

Apply the required knowledge and skills and exhibit critical thinking and problem solving.

Exhibit good work habits, including organizational skills, regular attendance, working independently, seeking and offering assistance when needed.

Work or volunteer experience working directly with consumers in social service type settings. Experience can be substituted for education.

Any combination of related education and relevant work experience equaling at least 4 years.

2 years previous experience working at or with an HMO or MCO organization required

A bachelor’s degree may substitute for the years of required work experience

Being fully vaccinated against COVID-19 is required for all employees unless approved for a medical or religious exemption

High school diploma or GED required

Manually update member eligibility data in the claims processing system using multiple sources for reference, including applications, databases, and reports

Research and resolve member eligibility issues thoroughly, timely, and accurately

Pharmacy benefits management experience preferred with specific knowledge of Medicare, Medicaid and commercially insured payer common practices and policies, preferred

Intermediate Microsoft skills with specific experience with Excel

Obtain and enter accurate benefit information to positively impact insurance processing and minimize rejections

Maintain quality while providing an empathetic and supportive experience to the patients, doctors, and physician offices

Previous healthcare experience with insurance or in pharmaceutical industry, preferred

Previous prior authorization and appeals experience highly desired

2 years previous experience working at or with an HMO or MCO organization required

A bachelor's degree may substitute for the years of required work experience

Being fully vaccinated against COVID-19 is required for all employees unless approved for a medical or religious exemption

High school diploma or GED required

Manually update member eligibility data in the claims processing system using multiple sources for reference, including applications, databases, and reports

Research and resolve member eligibility issues thoroughly, timely, and accurately