Eligibility Specialist

Overview

Supporting Community Healthcare is a rewarding role. LifeLong Medical Care is looking for an Eligibility Specialist at our Admin site in Berkeley. 

As part of the health center front office team, prepares and submits required eligibility screening and information for all patient visits at the health center. Also responsible for providing enrollment, assistance, information and support to new and established patients in determining eligibility for health services under various private and public health care assistance programs. Also serve as patient registrar and navigator for new patients to their health center. Provide screening and enrollment at community outreach events.

This is a full time, 40 hours/week, benefit eligible position. 

This position is represented by SEIU-UHW. Salaries and benefits are set by a collective bargaining agreement (CBA), and an employee in this position must remain a member in good standing of SEIU-UHW, as defined in the CBA.

LifeLong Medical Care is a large, multi-site, Federally Qualified Health Center (FQHC) with a rich history of providing innovative healthcare and social services to a wonderfully diverse patient community. Our patient-centered health home is a dynamic place to work, practice, and grow. We have over 15 primary care health centers and deliver integrated services including psychosocial, referrals, chronic disease management, dental, health education, home visits, and much, much more. 

Benefits

Compensation: $20 - $21/hour. We offer excellent benefits including: medical, dental, vision (including dependent and domestic partner coverage), generous leave benefits including ten paid holidays, Flexible Spending Accounts, 403(b) retirement savings plan.

Responsibilities

• Responsible for preparing all eligibility information for each scheduled clinic patient at least two days ahead of the appointed time. Works collaboratively with front desk staff to ensure that all scheduled and non-scheduled patients are checked for eligibility and that all information is entered accurately and thoroughly.
• Enters pertinent patient messages and eligibility alerts in patient’s chart where needed to communicate with front office and billing department  regarding patient eligibility
• Interviews and screens new and established patients to determine eligibility for health insurances and other programs including Medi-Cal, Covered California, CalFresh, HealthPAC and Contra Costa CARES.
• Assists patients and community members with completing and submitting applications for county and state benefit programs including Covered California.
• Registers new patients, schedules appointments and provides information on LifeLong Medical Care’s locations, services and available programs.
• As part of health center front office team, assists with front office operations at the health center as needed.
• Responsible for tracking and reporting all required data for enrollment and outreach efforts.
• Keeps appropriate statistical records.
• Attends all meetings that apply to the eligibility process and shares the information with appropriate clinic personnel. These meetings are typically off-site and may require the use of personal vehicle or other transit.
• Follows up on incomplete applications in OEA and CalHEERS within 30 days.
• Schedules Medi-Cal appointments for patients to meet with On-site Eligibility Workers.
• Takes all classes and test to become a Certified Enrollment Counselor
• Performs other duties and projects as assigned.

Qualifications

• Strong organizational skills and ability to work effectively under pressure in a positive, friendly manner.
• Excellent verbal and written communication skills.  Must be able to communicate at all levels.
• Patient and compassionate when interacting with patients and staff.
• Ability to work independently and as a team player with staff and volunteers.
• Work in a team-oriented environment with a number of professionals with different work styles and support needs.
• Excellent interpersonal, verbal, and written skills and ability to effectively work with people from diverse backgrounds and be culturally sensitive.
• Conduct oneself in external settings in a way that reflects positively on LifeLong Medical Care as an organization of professional, confident and sensitive staff.
• Ability to see how one’s work intersects with that of other departments of LifeLong Medical Care and that of other partner organizations.
• Make appropriate use of knowledge/ expertise/ connections of other staff.
• Be creative and mature with a “can do”, proactive attitude and an ability to continuously “scan” the environment, identifying and taking advantage of opportunities for improvement.

Job Requirements          

• High school diploma or GED.
• Two years’ experience in a community health care environment or primary care setting.
• Experience with One e-App and Cal-Win
• Knowledge of Medicare, Medi-Cal, HMO and PPO health insurance policies and procedures.
• Proficient in Microsoft office suite, able to type 35 wpm and produce spreadsheets, tables, and flyers.

Job Preferences              

• Some college preferred.
• Bilingual English/Spanish preferred.