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PG

Eligibility Specialist

Pride Global
🇺🇸 United States
Remote
Senior
11 months ago
  • FLSA
  • Excel
  • Outlook
  • PowerPoint
  • LPN
  • Health insurance
  • Pension
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#RTA
Russell Tobin's client a health insurance company is hiring  Eligibility Specialists  in Phoenix AZ.

 

Job Title: Community Assistor – Medicaid/Eligibility Specialist

Department: Medicaid

Location: Phoenix, AZ (remote)

Pay Rate:$19 - 20.85hr.

FLSA Status: Exempt / Nonexempt

Schedule: Full-time (40+ hours per week; evenings and weekends as needed)

Job Type: Contract

 

 

We are seeking a Community Assistor (Eligibility Specialist) to support Medicaid members through application renewals, outreach, and enrollment activities. This role focuses on ensuring a positive member experience, assisting with eligibility processes, and strengthening relationships with community partners.

  • Level 1 – Eligibility Specialist (Grade 9):
    Conducts HEAplus application renewals with current members during interactive interviews, supporting member retention efforts.
  • Level 2 – Senior Eligibility Specialist (Grade 10):
    Leads and assists in planning, developing, and organizing community outreach events and activities that drive enrollment and engagement.

 

Key Responsibilities

  • Conduct HEAplus application renewals and assist members in completing required forms and documentation.
  • Uphold member care standards and maintain confidentiality of personal information.
  • Build and foster relationships with community organizations and referral sources.
  • Represent company Medicaid programs at community events and outreach initiatives.
  • Communicate complex processes in a clear, step-by-step manner for members.
  • Maintain professional relationships with internal and external partners.
  • Submit required reports and summaries on processed applications.
  • Maintain a secure, private workspace for handling member information.
  • Perform additional duties as assigned.

 

Qualifications

Required

  • Experience (Level 1):
    • 1 year of telephonic customer service experience
    • 1 year of experience in outreach, marketing, or community relations
  • Experience (Level 2):
    • 1 year of telephonic customer service experience
    • 3 years of experience in outreach, marketing, or health plan services
  • Education:
    • High School Diploma or GED
  • Licenses:
    • Valid Arizona Driver’s License with an acceptable driving record

Preferred

  • Experience with AHCCCS/Medicaid, CHIP, health promotion, social services, or related fields
  • Bilingual in English and Spanish

 

Skills & Competencies

  • Strong customer service and communication skills (verbal and written)
  • Ability to multitask and manage time effectively in a fast-paced environment
  • Proficiency with Microsoft Office Suite (Word, Excel, Outlook, PowerPoint)
  • Strong interpersonal, organizational, and presentation skills
  • Ability to work independently while meeting deadlines and performance goals
  • Understanding of Medicaid and Medicare regulations and guidelines
  • Comfortable working evenings and weekends as needed
  • Ability to lift up to 25 pounds

 

Work Environment

This is a full-time position requiring at least 40 hours per week, plus additional hours as needed.

A dedicated, private work area is required to ensure confidentiality of sensitive member information.

 

Benefits that Russell Tobin offers:

Russell Tobin offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), a 401(k)-retirement savings, life & disability insurance, an employee assistance program, identity theft protection, legal support, auto and home insurance, pet insurance, and employee discounts with some preferred vendors.

 


For workers in the United States, PrideGlobal and it's affiliates offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, pet insurance and employee discounts with preferred vendors.

Equal Employment Opportunity
PrideGlobal and it's affiliates are an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law.

Fair Chance Employment
PrideGlobal and it's affiliates are a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including, the California Fair Chance Act and all applicable local Fair Chance ordinances.

Accommodations
We are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require a reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us.

Only applicable for San Francisco Candidates: Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.

Only applicable for Kentucky positions: For this type of employment, state law requires a criminal record check as a condition of employment. This applies to direct care staff (Examples: RN, LPN, Nurse Aides, Therapists) referred to Kentucky nursing facilities, assisted living communities, or long-term care facilities, in accordance with KRS 216.793.

Eligibility Specialist · Pride Global

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