Eligibility & Enrollment Specialist
$45,760–$45,760 year
On-siteSan Jose, California, United States
Job Summary
Meet new and established medical clients to enroll them in health insurance programs, County coverage, or Medi-Cal. Greet patients in the waiting room, assist with applications, and confirm appointments while maintaining the Medi-Cal eligibility schedule. Conduct outreach calls and mailings to American Indian clients and new managed care enrollees, creating incentives to reduce no-shows. Develop payment plans, compile monthly statistics for the Board Report, and prepare eligibility reports for registration. Provide backup to the receptionist and medical records as needed. Participate as a proactive representative of the Patient Centered Health Home model, attending outreach events as required. Work in a fast-paced medical environment from 8:00 am to 5:00 pm, with hours varying based on need.
Required Qualifications
- Associate degree in a medical related field or comparable
- A minimum of 2 years of experience in a medical setting in a similar position
- Able to read, write and speak English fluently
- Knowledge of medical terminology, procedure codes, ICD-9 codes, and medical records handling
- Trained as Certified Enrollment Counselor for Covered California or willing to complete training within 3 months of being hired
- Vast knowledge of Federal and State health programs, and Qualified Health Plans of Cover California
- Working knowledge of computer programs such as Microsoft Window
- Experience with Electronic Health Records and patient registries
- Flexibility, initiative, reliability, and creativity
- Willingness to cross train for reception and medical records
- Excellent customer service
- Knowledge of and ability to relate to the American Indian community and other minority populations
- Possession of a valid California Driver License, automobile insurance, and a clean driving record
- Ability to maintain strict confidentiality
- Ability to function independently and as a team member within diverse environments as well as with a diverse staff composition
- Demonstrated ability to perform multiple administrative functions simultaneously in an accurate, organized, and efficient manner
- Ability to multitask and thrive in a fast-paced, constantly changing environment
- Ability to carry out all responsibilities in an honest, ethical and professional manner and demonstrate good judgment
- Ability to sit, stand and walk for extensive periods of time
- Manual and finger dexterity and eye-hand coordination sufficient to accomplish the duties associated to your job description
- Ability to lift up to 35 pounds
- Ability to stoop, squat, or bend frequently
- Corrected vision and hearing within normal range to observe and communicate with patients and professional staff
Desired Qualifications
- Bi-lingual in Spanish preferred
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