What Does an Eligibility Specialist Do?

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  • Written By: Nick Mann
  • Edited By: Jessica Seminara
  • Last Modified Date: 11 January 2020
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A career as an eligibility specialist is suitable for individuals who enjoy working with the public and possess great interpersonal skills. This position usually involves working within a government agency or in the healthcare industry. The fundamental role of an eligibility specialist is to advise people on financial aid programs and determine who meets the requirements to receive aid. Consequently, some common job duties include answering public inquiries, interviewing applicants, checking applicant references, approving or denying financial aid and documenting each case.

Answering a variety of public inquiries on a daily basis is a large part of this job. When individuals have questions concerning different healthcare or government programs, an eligibility specialist is usually the one to provide answers. Depending upon the agency he works for, he may be responsible for knowing about only one program or potentially several programs. Performing this duty adequately requires an eligibility specialist to have expertise, in-depth knowledge of each financial aid program, and significant people skills.

Interviewing applicants is another important part of this position. For this practice, the specialist will usually meet with an applicant and discuss financial aid needs. If an applicant is seeking healthcare coverage, for example, an eligibility specialist might ask questions about the applicant's health history, current health insurance plan and other relevant information. He will also go over the application to ensure that everything is filled out correctly and the applicant appears to be eligible.


After he has interviewed an applicant and all the information looks good, an eligibility specialist will often check the applicant's references. This typically involves contacting employers and personal references in order to determine the legitimacy of an applicant's claims. Verifying this information is often mandatory before an applicant can be approved for assistance.

Once he has performed an initial interview and contacted some references, an eligibility specialist will either approve or deny an application. If approved, he will go over all necessary information and will provide the applicant with additional paperwork. When denying an application, he will explain the reasons behind the denial and explain what further actions can be taken to obtain financial aid.

An additional aspect of this job involves documenting each case. In most cases, an eligibility specialist will be required to fill out paperwork and enter information onto a computer. This practice helps to keep track of each applicant's files, which can be reviewed later on if necessary. To perform this action effectively, it helps for an individual to be organized.


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Post 2

Worst job I have ever had. You are overworked and underpaid. Management expects you to be able to do a three-person job by yourself. It was horrible and the best thing I did is resign and move on in life.

Post 1

Is the eligibility worker same as the eligibility specialist?

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