Eligibility Specialist - Credentialed
Pontiac, MI, United StatesYesterday
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Skills
About the role
Easterseals MORC is hiring for a Credentialed Eligibility Specialist to help make a difference and become part of something bigger than yourself!
We are looking for Game Changers!
The types of people who wake up excited to make a difference. The superheroes of their field who care about the people they serve. If that sounds like you, we want you on our team.
Benefits of Being a Superhero!
Benefits:
- Low-cost Dental/Health/Vision insurance
- Dependent care reimbursement, and up to 5 days paid FMLA for maternity, paternity, foster care and adoption.
- Generous 401K retirement plan
- Paid Leave Options Available
- Up to $125 bonus for taking 5 days off in a row.
- 10 paid holidays and 3 floating holidays (Over 30 days total of paid time off)
- Wellness Programs
- We are a PSLF (Public Service Loan Forgiveness) Employer.
- We provide bonuses and extra incentives to reward hard work & dedication.
- Mileage reimbursement in accordance with IRS rate.
- Free financial planning services through our partnerships with the LoVasco Consulting Group, and SoFi.
- Student loan repayment options
- Pet Insurance
Qualifications:
- Possess a Bachelor’s degree from an accredited college or university with a major in Psychology, Social Work, Human Services, Healthcare Administration, Public Health, or a related area.
- At least one (1) year of full-time experience in behavioral health, case management, Medicaid eligibility, benefits navigation, healthcare access, revenue cycle, or a related human services role.
- Must possess and maintain a valid Michigan driver's license and current auto insurance.
- Experience completing or supporting Medicaid, Healthy Michigan Plan, SSI/SSDI, or other public-benefit applications preferred.
- QMHP or QIDP certification preferred.
- SOAR Training preferred
Duties and Responsibilities:
The Eligibility Specialist - Credentialed assists individuals receiving behavioral health services with applications, renewals, and follow-up for Medicaid, Healthy Michigan Plan, Social Security benefits, patient assistance programs, and other available entitlements. The position monitors benefit status, helps gather financial and supporting documentation, coordinates with care teams and public agencies, and serves as a resource for navigating complex eligibility systems. The Specialist works proactively to prevent procedural disenrollment, restore coverage when gaps occur, and help ensure Easterseals MORC remains the payer of last resort.
- Meet with individuals to assist with applications and renewals for Healthy Michigan Plan, Medicaid, Social Security SSI/SSDI, patient assistance programs, and other applicable benefits.
- Coordinate eligibility support at intake and throughout services to confirm that appropriate benefits have been initiated, secured, and maintained.
- Monitor ongoing benefits and coverage status to support continuity of care and ensure Easterseals MORC remains the payer of last resort.
- Gather and review financial, identity, residency, disability, and other supporting documentation required for applications and renewals.
- Explain eligibility notices, renewal requirements, verification requests, deadlines, and next steps in a clear and understandable manner.
- Track applications, renewals, pending verifications, denials, closures, and reinstatement activity in designated systems and reports.
- Identify individuals at risk of procedural disenrollment or loss of coverage and take timely follow-up action.
- Assist with reapplication, reconsideration, reinstatement, or referral for appeal support when coverage is denied or terminated.