New 
Eligibility Specialist
 Spectraforce Technologies | |
 United States, North Carolina, Raleigh | |
| 500 West Peace Street (Show on map) | |
 Dec 17, 2025 | |
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Eligibility Specialist Remote; AZ time zone required 2 month contract (Opportunity to convert to FTE only if the worker is in AZ) Open to candidates in any state except Eastern time zone or CA Must haves: Bilingual required - English and Spanish Nice to haves: * Preferred industry background: health care exp preferred PURPOSE OF THE JOB The Eligibility Specialist conducts HEA plus application renewals to current members, during an interactive interview with the member to support member retention programs and represents Health Choice and during the process. (Level 1) The Eligibility Specialist Sr, plans, assist in development, and organize community outreach events and activities for the purpose of enrollment activity. The Eligibility Specialist, conducts HEA plus application renewals to current members (Level 2) REQUIRED QUALIFICATIONS 1. Required Work Experience * 1 year experience of telephonic customer service experience * 1 year of experience in outreach, marketing and/or community relations (Level 1) * 1 year experience of telephonic customer service experience (Level 2) * 3 years of experience in outreach, marketing and/or health plan (Level 2) 2. Required Education * High School Diploma or GED in general field of study 3. Required Licenses * Valid Arizona Driver License, with an acceptable driving record 4. Required Certifications * N/A PREFERRED QUALIFICATIONS * 1 year of experience in AHCCCS/Medicaid, CHIP, health promotion, community outreach, social services, marketing or related field (Level 1) * 3 years of experience in AHCCCS/Medicaid, CHIP, health promotion, community outreach, social services, marketing or related field (Level 2) ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES LEVEL 1 AND 2 * Upholds our member care standards * Excellent oral, written and interpersonal communication skills, and the capacity to multi-task in a structured work environment are required * Ability to handle confidential and personal information is critical * Build relationships with potential referral sources * Directly engage with the member on behalf of Health Choice and programs * Proficient in translating complex process into simple, step by step instructions members can understand and act upon * Must be able to work independently, multitask, and problem solve in a fast-paced environment ALL LEVELS * Submit weekly/monthly summary of processed application reports * Required to have a dedicated work area established that is separated from other living areas and provides information privacy * Ability to keep member sensitive documents secured * Promote Health Choice and brands to members * Demonstrated ability to listen skillfully, collect relevant information, and respond to customers in a compassionate manner * Maintain professional relationships with community partners and internal business partners * Build and foster community relationships with potential referral sources * Each progressive level includes the ability to perform the essential functions of any lower levels. * Perform all other duties as assigned * The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements REQUIRED COMPETENCIES 1. Required Job Skills (Level 1 and 2) * Computer experience necessary * Ability to organize multitask and prioritize work * Proficient computer skills, Microsoft Office Suite, Word, PowerPoint, Outlook and Excel * Ability to move fast and/or changing environment and with varying tasks, responsibilities or people * Effective time management and organizational skills * Effective interpersonal and communication skills, including presentation skills * Excellent customer service skills * Ability to manage multiple tasks and prioritize work to adhere to deadlines and identified time frames * Ability to lift to 25 pounds * Must be able to work weekends and evenings as needed. 2. Required Professional Competencies * Knowledge of the local health care community * Knowledge of Medicaid and Medicare regulations and guidelines * Ability to speak with people in a professional manner * Work cooperatively, positively, and collaboratively in an interdisciplinary team and with community partners and members * Effective verbal and written communication skills * Self-motivated * Strong leadership, planning and execution skills * Ability to think analytically and make independent decisions * Ability to manage large workload 3. Required Leadership Experience and Competencies * N/A | |