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Eligibility Manager Jobs in Colorado (NOW HIRING)

Eligibility Technician

Montrose, CO ยท On-site

$23.08 - $27.15/hr

Determines initial and continuing eligibility for food assistance, medical assistance, and cash ... Operates Colorado Benefits Management System (CBMS) to deliver benefits and utilizes pertinent ...

Eligibility Technician

Montrose, CO ยท On-site

$23.08 - $27.15/hr

Determines initial and continuing eligibility for food assistance, medical assistance, and cash ... Operates Colorado Benefits Management System (CBMS) to deliver benefits and utilizes pertinent ...

Long Term Care Eligibility Technician

Denver, CO ยท On-site

$47K - $61K/yr

About Our Job Long Term Care Eligibility Technician With competitive pay, great benefits, and ... Manage a full caseload, requiring well developed time management skills * Demonstrate ability to ...

RTD LiVE Eligibility Technician II

Denver, CO ยท Hybrid

$47K - $61K/yr

Experience with the Colorado Benefits Management System- CBMS (preferred, not required) * Previous experience determining eligibility * Ability to read, understand, interpret, and apply complex ...

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Eligibility Manager information

What is an eligibility manager?

An Eligibility Manager is a professional responsible for overseeing and managing the process of determining if individuals or groups qualify for specific programs, benefits, or services. They typically work for government agencies, healthcare organizations, or insurance companies. Their duties include supervising eligibility staff, ensuring compliance with policies and regulations, and resolving complex eligibility determinations or appeals. Eligibility Managers play a crucial role in making sure that assistance is provided to those who meet the necessary requirements, while preventing fraud and misuse of resources.

What are the key skills and qualifications needed to thrive as an eligibility manager, and why are they important?

To thrive as an Eligibility Manager, you need expertise in eligibility determination, compliance regulations, and case management, often supported by a bachelor's degree in social work, public administration, or a related field. Familiarity with eligibility management systems, case tracking software, and knowledge of relevant federal and state regulations is typically required. Strong leadership, problem-solving, and communication skills help in managing teams and resolving complex eligibility cases. These competencies are vital for ensuring accurate eligibility determinations, regulatory compliance, and efficient program operations.

What are the most common challenges faced by an eligibility manager in ensuring compliance with changing regulations?

Eligibility Managers often encounter challenges related to staying up-to-date with frequently changing federal, state, and local regulations that impact program eligibility criteria. They must ensure that their team is properly trained on new policies and that all documentation and procedures remain compliant. Additionally, balancing high caseloads while maintaining accuracy and timeliness in processing applications can be demanding. Effective communication with both applicants and internal departments is crucial to navigate complex cases and resolve discrepancies efficiently.

What is the difference between Eligibility Manager vs Claims Specialist?

CriteriaEligibility ManagerClaims Specialist
Required credentialsTypically requires a high school diploma or associate degree; certifications like Certified Eligibility Specialist are commonUsually requires a high school diploma; certifications like Certified Claims Professional are beneficial
Work environmentOffice setting, healthcare or insurance companiesOffice setting, healthcare or insurance companies
Employer and industry usageUsed in healthcare, insurance, government agenciesUsed in healthcare, insurance, and related sectors
Common search and comparison intentUnderstanding roles, responsibilities, and qualificationsUnderstanding differences in claims processing and eligibility

Eligibility Managers focus on verifying patient or client eligibility for services or benefits, ensuring compliance with policies. Claims Specialists handle processing and adjudicating insurance claims, focusing on reimbursement and accuracy. While both roles operate within healthcare and insurance sectors, Eligibility Managers primarily verify eligibility, whereas Claims Specialists manage claims processing.

What are the most commonly searched types of Eligibility jobs in Colorado?

The most popular types of Eligibility jobs in Colorado are:

What are popular job titles related to Eligibility Manager jobs in Colorado?

For Eligibility Manager jobs in Colorado, the most frequently searched job titles are:

What job categories do people searching Eligibility Manager jobs in Colorado look for?

The top searched job categories for Eligibility Manager jobs in Colorado are:

What cities in Colorado are hiring for Eligibility Manager jobs?

Cities in Colorado with the most Eligibility Manager job openings:

Infographic showing various Eligibility Manager job openings in Colorado as of August 2026, with employment types broken down into 100% Full Time. Highlights an 66% In-person, and 34% Remote job distribution.

Eligibility Technician

Montrose County, CO

Montrose, CO โ€ข On-site

$23.08 - $27.15/hr

Full-time

Re-posted 14 days ago


Job description

Pay Range:
$23.08 - $27.15 Hourly (DOE)
MONTROSE COUNTY BENEFIT INFORMATION:
2026 Montrose County Benefit Information
General Statement of Duties: Determines initial and continuing eligibility for food assistance, medical assistance, and cash programs. Operates Colorado Benefits Management System (CBMS) to deliver benefits and utilizes pertinent interfaces to access information. Conducts client interviews, compiles information and verifications and provides information to applicant on program benefits, program requirements, and community resources.
Supervision Received: Works under the supervision of the Eligibility Supervisor and performs a variety of routine work within established policies, procedures and receives detailed instructions on new projects and assignments. Work is checked occasionally.
Supervision Exercised: This position has no supervisory responsibilities.
Essential Functions: Any one position may not include all of the duties listed nor do the listed examples include all duties which may be found in positions of this class.
  • Conducts an initial interview with client to determine eligibility.
  • Explains program benefits and requirements and client and agency rights and responsibilities.
  • Interviews and gathers information such as income, resources, employability, education, and household composition.
  • Assists clients in completion of forms and in obtaining necessary documentation and verifications for program participation.
  • Answers client questions and assists in resolving problems that may arise.
  • Provides non-exempt clients with appropriate referrals to Work Programs, i.e. Family Support & Independence for Colorado Works applicants and Employment First for Food Stamp applicants.
  • Directs client in how to obtain an EBT card and provides information on use of the EBT card.
  • Compiles information and verifications supplied by client as documentation for case file.
  • Establishes organized case file to contain all documents related to client application and benefits delivery.
  • Verifies information provided by applicant through interfaces, electronic data providers, pay stubs, collateral contact with employers, bank statements, etc.
  • Researches data bases including Colorado Unemployment Benefits System (CUBS), Automated Child Support Enforcement System (ACSES), SVES, and SAVE to verify client information.
  • Adheres to processing guidelines established in program rules and regulations for approval/denial of benefits.
  • Maintains case notes as required both in case file and electronically.
  • Maintains caseload and client eligibility for benefits per program rules and regulations.
  • Processes reported changes in client status within program guidelines.
  • Reviews and completes data entry of periodic reports including MSRs, Food Stamp Change Reports, and RRRs.
  • Accesses and reviews monthly, weekly and daily reports to prioritize workload and meet guidelines for accurate and timely processing of cases.
  • Determines the need for restoration/recovery of funds or referral for fraud investigation.
  • Determines overpayments/underpayments and issues restorations or establishes claims as necessary.
  • Completes informational reports in cases of suspected fraud and assists fraud investigator in verification of information, using the case file, observations from interviews and other client contacts, and electronic records (e.g. CBMS).
  • Represents the department in appeal hearings when assigned.
  • Regular and predictable attendance is required.

MINIMUM QUALIFICATIONS
Required Knowledge, Skills and Abilities:
Education: An Associates or technical school degree or high school graduate or equivalent where two (2) years work experience in similar field equates to one (1) year of education.
Experience: Previous work experience dealing with a multi-cultural and multi-generational public is preferred. Bilingual writing, reading and speaking skills in Spanish may be preferred.
Required Knowledge: Knowledge of community service resources, activities, and purpose of service to the public. Ability to analyze and apply agency and state rules and regulations to assess computer determined eligibility approvals/denials. Ability to research, understand and adhere to state rules and regulations. Uses logic to problem solve.
Language Skills: Must have the ability to communicate effectively both verbally and in writing and the skill to organize materials and present information clearly and concisely in verbal and written form. Must understand and follow verbal and written instructions. Must have proficient knowledge of the English language, proper grammar, punctuation and spelling in other oral and written communication and have the ability to write routine reports and correspondences. Must be able to read, comprehend and apply laws, rules, regulations, policies and standard operating procedures required for this position, as well as, basic how-to documents and manuals.
Interpersonal Skills: Must have the ability to establish and maintain cooperative working relationships with fellow employees, representatives of other agencies and organizations and members of the community. Must have a strong customer focus orientation and have the ability provide information, answering questions and taking messages. Must be able to accept interruptions in a polite and effective manner. Must have the ability to be an effective team member and maintain sensitive and confidential information. Must maintain appropriate professional boundaries in relationships with customer/clients and the general public.
Mathematical Skills: Must have the ability to work with basic mathematical concepts such as addition, subtraction, multiplication and division and apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
Reasoning Skills: Must be able to apply basic principles of logic and reasoning to a variety of practical problems. Have problem solving and troubleshooting skills. Must have strong organizational skills and the ability to prioritize and work on multiple tasks. Must be able to exercise some independent judgment and function under pressure. Must be able to accomplish assigned tasks to meet established performance standards and objectives and thinks through the consequences of a decision prior to making it.
Office Technology/ Computer Skills: Must be able to apply basic principles of logic and reasoning to a variety of practical problems. Have problem solving and troubleshooting skills. Must have strong organizational skills and the ability to prioritize and work on multiple tasks. Must be able to exercise some independent judgment and function under pressure. Must be able to accomplish assigned tasks to meet established performance standards and objectives and thinks through the consequences of a decision prior to making it.
Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. While performing the duties of this job, the employee is regularly required to talk and hear. The employee frequently is required to sit and stand for long periods of time; use hands and fingers to handle or feel; and reach with hands or arms. The employee is required to stand, walk, climb or balance, twist, stoop, kneel, crouch. Must be able to respond to the customers' needs and perform tasks requiring extensive hand and eye coordination. Dexterity of hands and fingers to operate a computer keyboard, mouse and other devices and objects. The employee must occasionally be able to lift and/or move objects up to 25 pounds. Specific vision abilities required by this position include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. Physical ability and mobility to drive a motor vehicle to and from field and meetings as required. Ability to work extended shifts and attend training and meetings outside of regularly scheduled hours and the ability to work in stressful situations.
Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. Ability to tolerate and be productive in a quiet to moderate noise level in the work place. Employee will have periodic exposure to hazards in the field such as driving and inclement weather. Exposure to computer screens. May be exposed to potential angry, hostile, frustrated individuals and those with behavioral and/or cognitive challenges.
Special Requirements: Must possess and maintain a valid Colorado Driver's License and satisfactory driving record. Completion of mandatory HIPAA training and IS training courses 100 and 700 within one (1) year of hire.
Other Duties: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.