Eligibility Specialist

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Job Posting:
Eligibility Specialist

Location:
Access to Healthcare Network - Las Vegas Office Department:
Ryan White HIV/AIDS Program

Status:
Full-Time, Non-Exempt

Job Purpose

The Eligibility Specialist supports improved health outcomes for people living with HIV/AIDS by determining eligibility for Ryan White services, helping clients access public and private assistance programs, and identifying payer sources for the AIDS Drug Assistance Program (ADAP).

Key Duties & Responsibilities

Client Interaction

• Conduct eligibility screenings for Ryan White services and prescreen clients for the HIP program.
• Assist clients with applications, including Liberty Dental enrollment.
• Support clients in accessing medication and treatment needed for viral suppression.
• Refer clients to case management for medical and supportive services.
• Maintain professionalism, compassion, and confidentiality at all times (HIPAA‑compliant).

Community & Partner Interaction

• Build and maintain effective working relationships with AHN providers, members, community partners, and funders.
• Communicate professionally with staff and partner agencies.

Data & System Management

• Schedule appointments, maintain spreadsheets, and track ADAP payer sources.
• Enter and upload eligibility applications in CAREWare and RWISE.
• Complete pharmacy benefit manager data entry for ADAP services.

Insurance & Payment Assistance

• Preferably knowledgeable in Medicaid, Medicare A/B, Nevada Check-Up, and prescription programs.
• Assist clients with health insurance premiums, copays, deductibles, and tax‑related support programs.

Adaptability & General Expectations

• Adjust to changing work needs and perform duties as assigned.
• Attend required meetings and maintain compliance with all organizational policies.

Education & Experience

• Required: High school diploma
• Required: Bilingual English/Spanish
• Preferred: AA degree
• Community Health Worker Certification (within 1 year; agency-funded)
• Exchange Enrollment Facilitator License (within 90 days; agency-funded)
• 1 year of healthcare-related social work experience
• 2 years of experience with databases and Microsoft Office
• Preferred:
  Experience with CAREWare and Salesforce

Physical Requirements & Work Environment

• Ability to lift up to 30 lbs consistently
• Climate‑controlled office environment with moderate noise
• Ability to sit at a computer for 6-8 hours/day and stand 3-6 hours/day
• Frequent hand/wrist movement and repetition

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
• Prescription drug insurance
• 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!

* 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.

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.

Required to pass a background check through the State of Nevada