Eligibility Assistance Services Specialist (Grant Funded)

The Eligibility Specialist is the provision of a range of client-centered activities focused on improving access to and retention in needed core medical and support services. The Eligibility Specialist provides coordination, guidance, and assistance in accessing medical, social, community, legal, financial, employment, vocational, and/or other needed services. Services may also include assisting eligible clients to obtain access to other public and private programs for which they may be eligible, such as Medicaid, Children's Health Insurance Program, Medicare Part D, State Pharmacy Assistance Programs, Pharmaceutical Manufacturer's Patient Assistance Programs, Department of Labor or Education-funded services, other state or local health care and supportive services, or private health care coverage plans. Services includes all types of case management encounters (e.g., face-to-face, telehealth, phone contact, and any other forms of communication).

• Completes frequent face to face patient interactions completing intake application and all required forms. Obtains all documents for verification as defined by the standards. Determines eligibility for various Ryan White funded services (Part B and C) including HIV medical case management and ADAP, AIDS Drug Assistance Program, as well as other community resources. Schedules medical case management screening appointment.
• Obtains proper HIV status documentation and residency information.
• Performs the 6 month eligibility review and obtains necessary documents as defined by the standards,
• Complete required data entry into required patient database.
• Demonstrates and applies a thorough knowledge of benefit programs such as Medicaid, SSI/SSDI, Medicare, TANF, SNAP, Auxiliary Grant, etc. Coordinates with Carilion's Financial Assistance Program, MedKey, and hospital payment plan eligibility rules, regulations and procedures in order to assure accurate processing of accounts for billing and reimbursement when patient requires additional assistance.
• Maintains current information on all frequently used community resources, as needed.
• Collaborates with the team to ensure patient timely access to care and access to appropriate resources.