Eligibility Specialist - Bilingual - $24.04 per hour

• Community & Partner Interaction
• Build and maintain effective working relationships with AHN providers, clients, community partners, and funding agencies.
• Communicate professionally and effectively with internal staff and external partner organizations.
• Perform general administrative duties to support program operations and service delivery.
• Respond to inquiry calls and provide clear, accurate information regarding Ryan White program requirements and services.
• Maintain working knowledge of AHN services and other healthcare programs, including Medicaid, Medicare, Nevada Check-Up, and the Affordable Care Act.
• Participate in activities and responsibilities associated with state and county grant requirements, ensuring compliance and timely reporting.

• Data & System Management
• Schedule client appointments, maintain tracking spreadsheets, and monitor ADAP payer sources to support program operations.
• Accurately enter and upload eligibility documentation into database systems in a timely manner.
• Complete pharmacy benefit manager (PBM) data entry for ADAP-related services, ensuring accuracy and compliance.
• Handle protected health information (PHI) in strict accordance with HIPAA regulations and organizational policies.

• Insurance & Payment Assistance
• Demonstrate working knowledge of Medicaid, Medicare (Parts A & B), Nevada Check-Up, Affordable Care Act (ACA) plans, and prescription assistance programs.
• Assist clients with navigating health insurance-related costs, including premiums, copayments, deductibles, and access to tax-related assistance programs.

• Adaptability & General Expectations
• Demonstrate flexibility in adapting to changing priorities and organizational needs; perform additional duties as assigned.
• Attend required meetings and training sessions while maintaining compliance with all organizational policies, procedures, and standards.

• Education & experience required
• Bilingual (English and Spanish) – Required
• High school diploma or equivalent; AA Degree preferred
• Minimum of 1 year of experience in healthcare-related social services, case coordination, or patient support
• Minimum of 2 years of experience working with database systems and Microsoft Office applications
• Minimum of 1 year of general office or administrative experience
• Community Health Worker (CHW) Certification (to be obtained within 1 year; agency-funded)
• Exchange Enrollment Facilitator License (to be obtained within 90 days; agency-funded)
• Ability to successfully pass Medicare/Medicaid fraud screening

• Work environment & physical requirement
• The noise level in the work environment is usually moderate, and the employee usually works in a climate-controlled office environment
• Be able to sit at a computer for up to 6 – 8 hours per day
• Be able to stand between 3 – 6 hours per day.
• Be able to withstand frequent hand/wrist deviation and repetition
• Must be able to lift, carry up to 30 pounds with a fair consistency

The statements herein are intended to describe the general nature and level of the position, but are not necessarily a complete list of responsibilities, duties and skills required of employee(s) so classified. As such, responsibilities, duties, and required skills may be changed, expanded, reduced, or deleted to meet the business needs of Access to Healthcare Network. Furthermore, they do not establish a contract or implied contract for employment.

Funding clause

This position is funded through external grant sources. Continued employment is contingent upon the ongoing availability of this funding. If funding is reduced or discontinued, the position may be changed or eliminated.

As an equal opportunity employer, we are committed to identifying and developing the skills and leadership of people from diverse backgrounds. We encourage all qualified candidates to apply.

Benefits

• Medical Insurance & Vision provided at no cost to the Employee
• Health Savings Account HDHP (HSA) includes employer matching $35.00 per month
• Dependent Care Flexible Savings Account (FSA)
• Low-cost health insurance options for your dependents
• Dental Insurance
• Free Life Insurance and Long-Term Disability
• Voluntary Ancillary Benefits
• 4 Weeks Paid Time off in your first year
• WFH Options
• 14 Holidays
• Bereavement Leave
• 4 weeks Paid parental leave
• Tuition Assistance and more!

Required to pass a background check through the State of Nevada