Eligibility Specialist

Overview

About Children’s Specialized ABA is designed to address the comprehensive needs of children diagnosed with Autism Spectrum Disorder (ASD). By leveraging the expertise of the Children’s Specialized Hospital Autism Center of Excellence, the program aims to expand access to innovative and compassionate care, empowering children diagnosed with autism to thrive. Children’s Specialized ABA offers home-based, community-based, and center-based ABA therapy. At Children’s Specialized ABA, we envision a future where every child diagnosed with autism has access to innovative and compassionate care, empowering them to thrive and reach their full potential.

Our vision is built on four core values:
Inclusivity, Innovation, Connection, and Quality and Safety.

• Join as an Eligibility Specialist in Behavioral Health and determine the eligibility of individuals seeking behavioral health services. Ensure that all applicants meet the criteria for various insurance programs and behavioral health services.
• Assist clients in navigating the application and billing process, verify insurance benefits, and ensure that all necessary documentation is accurate and complete.
• Maintain accurate records of client eligibility, including data entry and documentation in relevant systems such as EHR and CRM.
• Assess clients’ financial situations and recommend appropriate assistance programs, ensuring compliance with state and federal guidelines.
• Respond to client inquiries regarding eligibility status during the intake process.
• Collaborate with intake, clinical staff, and insurance providers to ensure timely processing of eligibility determinations.
• Maintain up-to-date, accurate records of all client eligibility and related documentation.
• Ensure that all required documents (e.g., income verification, insurance coverage) are received and processed in a timely manner.
• Work closely with clinical and administrative teams to ensure seamless intake and eligibility processes.
• Communicate with clients about their financial responsibility and educate them on available services.

• High school diploma or equivalent (GED)
• 2+ years of medical insurance verification and eligibility OR 1 year of behavioral health insurance verification
• Experience using an electronic records medical system.
• Bilingual in English / Spanish is a plus
• Detail oriented, strong organizational, time management, analytical, problem solving, and customer service skills.
• Ability to multitask and track multiple items at the same time.
• Exceptional verbal, written, and interpersonal communication skills, including phone and email.
• Proficient in Microsoft Office, Google Sheets and Google Docs, with strong computer skills.
• Ability to work in a fast-paced environment with changing circumstances while maintaining a positive attitude.

This is a full-time position in a hybrid work setting that can be in either our Owings Mills or Beltsville, MD EI Centers. The core hours are 8:30am to 5:00pm.

• Up to 19 paid days off in your first year (including PTO, sick time, and holidays); earned on an accrual basis, paid time off increases with tenure
• Comprehensive benefits including free medical (employee; buy-up for dependent/partner coverage), voluntary dental, vision, short-term disability, critical illness coverage, and more
• Free 50k life insurance policy
• Free Employee Assistance Program (EAP)
• 401(k) retirement savings plan
• Company discount program – discounts on amusement parks, memberships, cruises, movie tickets, spas, sports tickets and more

A reasonable estimate of the pay range for this position is $19.00 to $23.00 per hour. There are numerous factors considered in determining the actual offered rate, including job-related qualifications, experience, skills, education, geographic location, and internal equity considerations.

Children’s Specialized ABA provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.