As an Eligibility Specialist I, you’ll play a vital role in connecting Maine residents to the health coverage they need through MaineCare—the state’s largest health insurance program serving lower-income adults, children, older adults, and people with disabilities. In this position, you’ll help people navigate important life situations while ensuring accuracy in determining eligibility. The work is fast-paced, collaborative, and mission-driven with a strong focus on customer service, problem solving, and teamwork.
• Evaluate information and apply program standards to accurately determine MaineCare eligibility and benefits.
• Use multiple technology systems to enter, review, and verify eligibility-related data and documentation.
• Clearly explain MaineCare rules, requirements, and decisions to applicants and members—both in writing and over the phone.
• Review and process information received electronically or by mail to ensure completeness and compliance.
• Connect individuals with additional programs and services that may support their health and well-being.
Strong communication and interpersonal skills are essential as you’ll work with people from diverse backgrounds, with varying needs, and help them navigate complex systems during moments that matter.