Job Description

TITLE: Outreach Eligibility Specialist

DEPARTMENT: Administration

REPORTS TO: Director of Business and Finance

FLSA STATUS: Non – Exempt

STATUS: Full Time

WAGE: $18.00-19.50/hr

POSITION SUMMARY

The All Nations Health Center Eligibility Specialist works with All Nations clients and potential clients to

determine access for health coverage eligibility. The Outreach Eligibility Specialist serves as a team

member of the Connecting Kids to Coverage program, which is aimed at ensuring Native children, families,

and pregnant people have access to healthcare coverage under Montana State Medicaid, Healthy Montana

Kids (HMK), and Children’s Health Insurance Program (CHIP). The Eligibility Specialist is responsible for

helping All Nation’s clients and prospective clients with health insurance applications, renewals, and other

eligibility determination processes. This position works closely with other members of the Connecting Kids

to Coverage program and the Finance Department.

DUTIES & RESPONSIBILITIES

• Conduct financial fact-finding interviews with patients who are seeking healthcare benefits to

determine eligibility based on income, household size, employment, etc.

• Provide Medicaid/HMK/CIP navigation assistance to current and prospective clients off-site at

outreach events, WIC office, Early Headstart, University of Montana, and other partner institutions.

• Maintain up-to-date knowledge and understanding of available healthcare coverage options for

All Nations clients.

• Regularly participate in trainings, conferences, and cohort meetings with other Eligibility

Specialists to expand knowledge base related to Montana State laws regarding health

coverage.

• Complete Medicaid/HMK/CHIP and other applicable applications/releases.

• Monitor all applicants who are eligible for Medicaid or other financial assistance or coverage

plans, as required.

• Enter clear and concise notes in the required patient accounting systems.

• Ensure all supporting documents, including applications and receipts, are obtained and filed

timely.

• Successfully help coordinate and manage the portfolio of Medicaid/HMK/CHIP applicants.

• Adhere to all relevant regulations related to involvement with local, state and federal government

programs as well as All Nations and our clients’ compliance programs.

• Provide excellent internal and external customer service to All Nations clients, staff, and

community.

• Interface with external revenue system/billing and coding partners to ensure that

Medicaid/HMK/CHIP statements are accurate and meet timely filing deadlines.

• When clients are determined ineligible for state-sanctioned health coverage options, assist

clients in navigating third-party options to ensure health coverage is attained.

• In conjunction with other interdisciplinary team members, assist in coordinating and

implementing outreach events that provide the Missoula community with

opportunities to access help with health coverage.

• Assist in and facilitate data collection and analysis regarding outreach events, number of

eligible applications submitted, number of clients assisted, etc.

• Report monthly on enrollment analytics.

• Other duties as assigned.

PREFERRED SKILLS

• Knowledge of industry-specific programs as they relate to Indian Health and Urban Indian

Health.

• Expert competence using computers and the internet.

• A sense of commitment to the unique needs of the Native American population and All Nations

programming.

• Attention to detail with proficient planning and organizational skills, sufficient to prioritize and

successfully complete job demands.

• Ability to work independently and/or with minimal supervision, as well as, ability to clearly

follow supervisor instructions.

• Ability to interact with and understand cultural differences and apply skill in working with people

of varied social, ethnic and economic backgrounds.

• Ability to exercise tact and diplomacy, to gain confidence, support and cooperation of individuals

and groups in accomplishing objectives.

• Flexibility and adaptability to stress and ability to work under stressful situations, when

necessary; and apply conflict resolution skills for effective outcomes.

PREREQUISITE QUALIFICATIONS

• Associate’s degree, or equivalent professional experience, in business, communication, billing

and coding, community health, prevention sciences, or other relevant field.

• Working knowledge of urban, tribal, or federal healthcare setting providing insurance and

eligibility services, or willing to learn.

• Candidate must have reliable transportation, a valid Montana driver’s license, and be willing to

consent to criminal background checks.

REQUIRED

• Proficient computer skills, including Microsoft Office (specifically Word and Excel), electronic

medical records, email, and database software.

• Excellent leadership, organizational, written and verbal communication, and interpersonal skills.

• Demonstrate sound judgment, decision-making, critical thinking, and problem-solving skills.

• Ability to maintain confidentiality and privacy consistently and constantly with all aspects of

information in accordance with practice, state, and federal regulations.

• Practice, develop, and endorse strong internal and external customer service skills.

• Ability to read, understand, follow and enforce safety procedures.

• Ability to work with a high-risk, minority population and maintain emotional stability to cope

with human suffering, emergencies, and other stressors.

• Ability to work effectively at all levels in a collaborative, customer service-oriented, team

environment.

• A high school diploma is required.

• Valid MT Driver’s License and clean driving record

• Be willing to consent to criminal background check

Employees may be requested to stay or report to work, when needed, to complete essential tasks to the

benefit of the organization. This may require working a non-traditional work schedule or working outside

normally assigned duties to complete tasks.

PHYSICAL DEMANDS

Essential job duties may require occasional lifting, pushing, and pulling up to 25 pounds. The ability to

occasionally stoop, kneel, crouch and utilize reaching, handling, fingering, and feeling movements is

required. The ability to hear the normal conversational discussion and near and far visual clarity is required.

Benefits: Health Insurance, Retirement, Dental Insurance