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Eligibility Manager Jobs in Virginia (NOW HIRING)

City of Danville

Eligibility Worker

Danville, VA · On-site

$38K - $40K/yr

Description Determine eligibility for Temporary Assistance for Needy Families (TANF), Supplemental ... managing referrals for other situations when needed. Attend trainings as required. ADDITIONAL ...

City of Danville, VA

Eligibility Worker

Danville, VA · On-site

$38K - $40K/yr

Determines eligibility for public assistance and benefits by gathering personal and financial ... managing referrals for other situations when needed. * Attend trainings as required. ADDITIONAL ...

City of Danville, VA

Eligibility Worker

Danville, VA · On-site

$38K - $40K/yr

Determines eligibility for public assistance and benefits by gathering personal and financial ... managing referrals for other situations when needed. * Attend trainings as required. ADDITIONAL ...

PonosCare

VA-Eligibility Specialist

Richmond, VA · On-site

Organizational Overview Ponos Management, Inc. is a mission-driven healthcare organization ... Position Overview The Eligibility Specialist serves as a key member advocate responsible for ...

GovernmentJobs.com

Eligibility Worker I

Spotsylvania, VA · On-site

$20.25 - $27.25/hr

... and manages assigned caseload; establishes prioritizes and schedules appointments. • Prepares ... Determination of eligibility and level of benefits is reviewed by Supervisor or her designee. • ...

New

Spotsylvania County

Eligibility Worker I

Spotsylvania, VA · On-site

$20.25 - $27.25/hr

... and manages assigned caseload; establishes prioritizes and schedules appointments. • Prepares ... Determination of eligibility and level of benefits is reviewed by Supervisor or her designee. • ...

Mission Hospital

Medicaid Eligibility Advocate

Roanoke, VA · On-site

$15 - $22.50/hr

The Medicaid Eligibility Advocate is a liaison between the patient, hospital, and governmental agencies and is actively involved in all case management areas. In this role you will: * Screen and ...

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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 Virginia?

The most popular types of Eligibility jobs in Virginia are:

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

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

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

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

What cities in Virginia are hiring for Eligibility Manager jobs?

Cities in Virginia with the most Eligibility Manager job openings:

Eligibility Manager jobs near you
Infographic showing various Eligibility Manager job openings in Virginia as of August 2026, with employment types broken down into 85% Full Time, 14% Part Time, and 1% Contract. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution.

Eligibility Specialist

Business Benefits Group

Fairfax, VA • On-site

Full-time

Re-posted 3 hours ago

Job description

Make Business Benefits Group (BBG) your last career move.  This is an amazing opportunity to join a rapidly growing agency, with great work/life balance and endless income opportunity for those that embody and embrace our Core Values.  Our team members all contribute to the overall success of the agency, and the rewards are limitless.  Join our fantastic team today! 
Position Responsibilities:
The Eligibility Specialist is responsible for processing all client eligibility changes and ID card request in a timely and accurate manner. This position will also respond to request from clients and agency employees, update the client management portal, communicate effectively with clients and carrier representatives, attend team meetings, and provide exceptional customer service to maintain strong client relationships.
Desired skills, experience and position requirements:
  • Process all client eligibility changes and ID card requests with precision and within specific timeframes. 
  • Respond to client and internal requests in a timely and accurate manner. 
  • Update the client management portal with the most recent information. 
  • Maintain effective communication with clients and carrier representatives, ensuring their needs are met and questions are answered. 
  • Attend team meetings to stay informed about agency policies, procedures, and industry updates.  
  • Provide accurate and timely support to clients to enhance their trust and loyalty with BBG. 
  • Possess a strong customer service orientation and demonstrate a good understanding of insurance concepts. 
  • Navigate online portals efficiently to access and update client information. 
  • Communicate difficult carrier decisions to clients when necessary, and escalate issues to carrier representatives, when appropriate. 
Required Skills & Abilities:
  • Excellent communication skills, both written and verbal, to convey information clearly and transparently. 
  • Strong organizational skills, with the ability to prioritize tasks and manage daily responsibilities effectively. 
  • Display a high level of attention to detail when entering data and reviewing documents to avoid errors and ensure data integrity. 
  • Provide empathetic and supportive assistance to clients and employees by being responsive to client needs and proactively seeking opportunities to enhance the client experience. 
  • Ability to work effectively in a team environment and collaborate with team members and other departments. 
  • Familiarity and proficiency in using relevant software applications, including Customer Relationship Management (CRM) systems, Microsoft Office Suite, and other tools used for client management and communication. 
  • Commitment to staying updated on industry trends, regulations, and best practices. 
  • Adhere to ethical standards and maintain confidentiality when handling sensitive employee and client information. 
 Required license or certification:
  • Life & Health License or ability to obtain within 90 days of hire
Work Environment & Physical Demands 
 
This position can be performed remotely, on a hybrid schedule, or full time in an office. The Data Entry Specialist operates within a professional work environment. The work environment is characterized by a collaborative and client-focused atmosphere, fostering teamwork and open communication. The work setting is equipped with modern technology and software necessary to perform job responsibilities effectively. The noise level for this position can range from low to moderate, depending on the specific work environment.   
 The Data Entry Specialist may occasionally need to adapt to changing work demands, such as handling urgent client requests, participating in team meetings, or assisting colleagues during peak periods.  
 The Data Entry Specialist should be prepared to engage in a variety of activities that require physical effort and mobility: 
  • Sitting: A significant portion of the workday involves sitting at a desk while using a computer, handling paperwork, and communicating with clients and co-workers. 
  • Standing and Walking: If reporting to an office, some tasks, such as attending in person meetings, interacting with colleagues, and moving within the office space, may involve standing and walking. 
  • Typing and Writing: This position requires frequent typing, data entry, and documentation. Effective written communication is essential for drafting emails, reports, and client communications. 
  • Lifting and Carrying: If reporting to an office, the Data Entry Specialist may need to lift and carry files or documents, generally weighing up to 10 pounds. 
  • Telephone and Communication: This position involves significant telephone communication with clients, carriers, and team members, requiring clear and effective verbal communication. 
  • Visual and Auditory Abilities: The ability to read documents, analyze data, and view computer screens for extended periods is necessary. Good auditory skills are essential for effective communication via telephone and in-person conversations. 
  • Multitasking and Time Management: This position often involves managing multiple tasks simultaneously and prioritizing time effectively to meet client needs and deadlines. 

 

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