Eligibility Specialist

Description

Participates in patient eligibility determination for Ryan White (RW) programming. Remains current on patient eligibility requirements and enrollment protocols. Serves the as primary contact in the management of Ryan White database utilized in documenting Clinic activity and the annual  completion of the Ryan White Service Data Report (RSR)

DUTIES AND RESPOSIBILITIES

· Maintains the Ryan White database system reflecting Clinic services related to Ryan White eligible patients, i.e. Take Charge Texas (TCT) or any other Ryan White related database systems.

· Determines patient eligibility insuring Ryan White compliance. Interviews and gather information from patients as required.

· Completes necessary forms and maintains complete and accurate records on clients.

· Complies with Ryan White, state and private funding requirements.

· Participates in audit preparations and reporting requirements for Ryan White programing.

· Works closely with Clinic Manager regarding compliance with all Ryan White policies, procedures and protocols implemented for program compliance.

· Participates in the agency's Quality Improvement Program.

· Understands and upholds CentroMed’s mission and values relating to ethics, integrity, safety, corporate responsibility and objectives.

· Actively participates in maintaining high levels of excellent customer service internally and externally.

· Abides by all policies and procedures set forth by CentroMed.

· Ensure the protection and security of a consumer’s personal, confidential and identifiable information in a professional and responsible manner and carry out all measures to prevent unauthorized disclosures. Demonstrating and maintaining the standards and requirements of the Health Insurance Portability and Accountability Act (HIPAA).

· Assists in training new employees in performing their duties as requested.

· Performs all duties in conformance to appropriate safety and security standards.

· Participate in the agency’s Quality Improvement Program.

· Performs other duties as assigned.

· Work must be performed on-site as designated.

Requirements

QUALIFICATIONS:

Education : High School Graduate or equivalent

Experience: At least 6 months experience in a health care setting – preferably a public health setting.

Other : Use of calculator, computer experience preferred

Must be able to establish a positive working relationship with other staff members and the public.

Must have working knowledge of basic math.