Eligibility Specialist

Job ID
Employment Type
Hours Per Week


The Eligibility Specialist is responsible for assisting hospital patients with the completion of the application process for any applicable governmental medical assistance programs which could include Medicaid, Disability, or Charity programs.  The Eligibility Specialist not only acts as an advocate for the patient, but also serves as a liaison to other Team members and to client hospital and government agency staff in a collaborative effort to facilitate eligibility coverage for incurred medical expenses. 




  • Provides superior customer service and maintains a professional image
  • Understands and meets the client’s needs, internal procedures and goals
  • Produces results that exceed expectations
  • Communicates effectively with multiple constituencies within the facility
  • Establishes and maintains strong working relationships 
  • Review referrals and screen for potential eligibility in appropriate federal/state/local program
  • Contact patient or their representative ASAP to complete the appropriate application and acquire all necessary releases, signatures, documents (including the birth certificate), etc.
  • Submit the application and any acquired documentation in a timely manner to the appropriate agency
  • Advise the applicant of all additional required documentation needs and time frames for compliance
  • Thoroughly enter all actions taken in the hospital account and in the internal data base/system 
  • Maintain structured and timely contact with the applicant and responsible government agency, by phone whenever possible
  • Assist the applicant with gathering any additional reports or records,  meeting appointment dates and times and arrange transportation if warranted
  • Conduct home visits as needed to acquire documentation
  • As per established protocols, inform the client in a timely manner of all approvals and denials of coverage
  • Thoroughly enter all actions taken in the hospital account and in the internal data base/system


  • Fluent in both English and Spanish
  • Requires 1+ years of related experience
  • Excellent communication skills, both verbal and written, with the ability understand users’ questions and effectively disseminate technical information 
  • Computer data entry and word processing skills and ability to operate routine office equipment
  • Working knowledge of computer programs, including Microsoft Excel
  • Ability to type at least 30 WPM

Preferred Skills

  • Experience in hospital business office and/or Medicaid casework
  • Knowledge of Government eligibility program requirements 

About nThrive

nThrive is the leader in providing end-to-end revenue cycle services, technology and education solutions. Previously known as MedAssets, Precyse, Equation and Adreima, each formerly a leader in its own right, we’ve combined our talents and capabilities into a single enterprise. At nThrive, we are people who are passionate about empowering health care for every one in every community. We work together to transform financial and operational performance, enabling health care organizations to thrive.
nThrive is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.


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