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Eligibility Manager Jobs (NOW HIRING)

DFR

Eligibility Specialist - Case Manager

Hobart, IN · On-site

$18/hr

Previous experience as a Case Manager, Eligibility Specialist, Eligibility Associate, Office Manager, Call Center Customer Service Specialist, or Client Specialist encouraged to apply The Eligibility ...

DFR

Eligibility Specialist - Case Manager

Marion, IN · On-site

$18/hr

Previous experience as a Case Manager, Eligibility Specialist, Eligibility Associate, Office Manager, Call Center Customer Service Specialist, or Client Specialist encouraged to apply The Eligibility ...

DFR

Eligibility Specialist-Case Manager

Fort Wayne, IN · On-site

$18/hr

Previous experience as a Case Manager, Eligibility Specialist, Eligibility Associate, Office Manager, Call Center Customer Service Specialist, or Client Specialist encouraged to apply The Eligibility ...

DFR

Eligibility Specialist - Case Manager

Shelbyville, IN · On-site

$18/hr

Previous experience as a Case Manager, Eligibility Specialist, Eligibility Associate, Office Manager, Call Center Customer Service Specialist, or Client Specialist encouraged to apply The Eligibility ...

DFR

Eligibility Specialist - Case Manager

Fowler, IN · On-site

$16.50/hr

Previous experience as a Case Manager, Eligibility Specialist, Eligibility Associate, Office Manager, Call Center Customer Service Specialist, or Client Specialist encouraged to apply The Eligibility ...

DFR

Eligibility Specialist -Case Manager

Knox, IN · On-site

$16.50/hr

Previous experience as a Case Manager, Eligibility Specialist, Eligibility Associate, Office Manager, Call Center Customer Service Specialist, or Client Specialist encouraged to apply The Eligibility ...

DFR

Eligibility Specialist - Case Manager

Washington, IN · On-site

$16.50/hr

Previous experience as a Case Manager, Eligibility Specialist, Eligibility Associate, Office Manager, Call Center Customer Service Specialist, or Client Specialist encouraged to apply The Eligibility ...

DFR

Eligibility Specialist - Case Manager

Columbus, IN · On-site

$18/hr

Previous experience as a Case Manager, Eligibility Specialist, Eligibility Associate, Office Manager, Call Center Customer Service Specialist, or Client Specialist encouraged to apply The Eligibility ...

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How much do eligibility manager jobs pay per hour?

As of Sep 6, 2026, the average hourly pay for eligibility manager in the United States is $22.65, according to ZipRecruiter salary data. Most workers in this role earn between $19.23 and $25.96 per hour, depending on experience, location, and employer.

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.

More about Eligibility Manager jobs

What cities are hiring for Eligibility Manager jobs?

Cities with the most Eligibility Manager job openings:

What are the most commonly searched types of Eligibility jobs?

The most popular types of Eligibility jobs are:

What states have the most Eligibility Manager jobs?

States with the most job openings for Eligibility Manager jobs include:

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

The top searched job categories for Eligibility Manager jobs are:

Eligibility Manager jobs near you
Infographic showing various Eligibility Manager job openings in the United States as of August 2026, with employment types broken down into 100% Full Time. Highlights an 67% In-person, and 33% Remote job distribution, with an average salary of $47,119 per year, or $22.7 per hour.

Eligibility and Outreach Specialist - West Phoenix

ADELANTE HEALTHCARE INC

Phoenix, AZ • On-site

Full-time

Re-posted 11 days ago

Adelante Healthcare rating

7.9

Company rating: 7.9 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

Job description

POSITION SUMMARY
Primarily responsible for promoting health insurance programs through coordinated comprehensive and effective outreach efforts. Will greet incoming patients/clients, screen for medical coverage eligibility available through different programs and assist with the application process, register patients, and provide information regarding Adelante Healthcare, Inc. Will attend outreach events and promote Adelante Healthcare services. Work is performed under the direct supervision of the Eligibility Manager at each site.
EXPECTATIONS
Every Adelante employee will strive to maximize their performance and contribution to Adelante Healthcare and the community we serve every day. Employees are expected work in a manner that demonstrates a commitment to quality, patient safety, employee engagement, innovation, and the highest standards of personal integrity, professionalism and competence.
OUR CORE VALUES
  • Compassion
  • Excellence
  • Integrity
  • Learning
  • Respect
  • Sustainability

ESSENTIAL SKILLS AND EXPERIENCE
  • Certification to perform cardiopulmonary Resuscitation for the Health Care Professional (CPR) and AED through courses that follow the guidelines from the American Heart Association and Red Cross (cognitive and skills evaluations)
  • Valid Level One Fingerprint Clearance Card issued by the Arizona Department of Public Safety for all specialty behavioral health locations
  • High School Diploma or GED from an accredited institution
  • Minimum one (1) year experience in medical front office, customer service and/or experience in sales, interview techniques, and extensive public relations/contact work
  • Experience and knowledge of health care programs available through state and federal programs such as Medicaid/AHCCCS, DES, etc.
  • Bilingual English/Spanish. Must have the ability to communicate effectively with monolingual Spanish speakers
  • Ability to write routine reports and correspondence, utilizing excellent English, spelling, and punctuation skills
  • Ability to calculate figures and amounts such as discounts, interest, and percentages
  • Ability to interpret a variety of instructions furnished
  • Strong familiarity with human service agencies serving low-income and minority populations and understanding of and sensitivity to issues of concerns to low-income and minority communities
  • Ability to meet and deal effectively with clients, associates, and the general public
  • Basic computer efficiency, with the ability to utilize the Patient Management system
  • Valid AZ drivers license
  • Ability to drive to any of our locations and other areas in Maricopa County to cover at other sites and provide outreach.
  • Competency in dealing with people of various cultures and backgrounds

NONESSENTIAL SKILLS AND EXPERIENCE
  • Associates Degree from a two year college in a health care or related field
  • Three (3) years of experience in community health

The qualifications listed above are intended to represent the minimum skills and experience levels associated with performing the duties and responsibilities contained in this job description. The qualifications should not be viewed as expressing absolute employment or promotional standards, but as general guidelines that should be considered along with other job related selection or promotional criteria.
POSITION REPONSIBILITIES/ESSENTIAL
  • Welcome patients and provide information on health care programs. Greet patients/clients, screen for appropriate medical coverage eligibility available through state programs, and assist patient/client in application process for medical programs, track applications in progress for completion by continued contact with patient/client and assist patient/client with problem application
  • Register patient/client with Adelantes health center for primary health care and promote and register patient/client for other available programs within Adelantes facility
  • Assure patients are registered under correct eligibility and corresponding pay code. Accurately update patient records accordingly for eligibility. Maintain current status of work in progress with accuracy and productivity at measured benchmarks
  • Guide and assist patients/clients in utilizing recommended services as indicated by medical referral and make appropriate referrals to community agencies on a case by case basis. Orient patients/clients to care delivery system and available resources.
  • Share pertinent information regarding health programs
  • Drive to various locations in Maricopa County, including, but not limited to, other Adelante Healthcare facilities to provide outreach and eligibility services
  • Present to other community partners on what services Adelante Healthcare offers
  • Attend community outreach events to promote Adelante Healthcare services

Additional Duties and Responsibilities
  • Other duties as request or assigned

PCMH
All employees are responsible for promoting and participating in interdisciplinary communication and collaboration to enhance the delivery of quality across the health care system. Employees should maintain an environment which supports and engages patients and co-workers in a caring team based model to promote wellness and improve health outcomes.
Adherence to Compliance and Code of Conduct
All employees are required to comply with Adelante Healthcares written standards, including its Compliance Program and Standards of Conduct, policies and procedures and reporting of any conduct that potentially violates Adelantes legal or compliance requirements. Such compliance will be an element considered as part of the regular performance evaluation.
PHYSICAL DEMANDS AND WORK ENVIRONMENT
The physical demands and work environment characteristics 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 the essential functions.
Physical demands: While performing the duties of this job, the employee may be required to sit for long periods of time, is required to stand, walk, use hands to handle or feel objects, tools or controls; reach with hands and arms; climb steps/stairs; balance; stoop, kneel, crouch or crawl; talk or hear; smell; manage stress as it relates to essential job functions. The employee must frequently lift and/or move up to 25 pounds without assistance, and may occasionally be required to lift or move up to 50 pounds with assistance. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
Work environment: While performing the duties of this job, the employee is exposed to weather conditions prevalent at the time when traveling to various clinic sites. The noise level in the work environment is usually moderate. The employee may be subject to health hazards (contagious diseases, blood borne pathogens, etc.) when working in the clinic area.
In any organization or job, changes take place over time. Although an effort will be made to keep job-related information current, this is not an all-inclusive list of job responsibilities. Adelante Healthcare, Inc. reserves the right to revise or change job duties and responsibilities as the business need arises. In compliance with EEOC 29 CFR part 1630, if the essential functions of this position cannot be performed in a satisfactory manner by the employee, further accommodations shall be made if it does not constitute undue hardships upon this organization.

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