ELIGIBILITY & ENROLLMENT COUNSELOR

RAVENSWOOD FAMILY HEALTH CENTER•East Palo Alto, CA

3d•$27 - $32

About The Position

The Eligibility & Enrollment Counselor, also referred to as a Community Health Advocate (CHA), works under the direct supervision of the CHA Supervisor to screen and assist uninsured adults and children with enrollment in San Mateo and Santa Clara Counties. The counselor becomes a Certified Enrollment Counselor (CEC) through the State of California, completes Community Health Advocate training through County partners, and participates in community enrollment sites and health events. The role includes eligibility screening, enrollments, responding to inquiries, and registering or re-registering Ravenswood Family Health Network (RFHN) patients. The counselor helps applicants gather verification documents, enter application information into relevant systems, understand coverage and payment details, and navigate additional services. They maintain accurate case management records and patient confidentiality, register patients in RFHN’s systems, and provide courteous front-desk and telephone support. The role may also require telephone enrollments, home visits, and floating between Ravenswood and MayView campuses. Ravenswood Family Health Network’s mission is to improve community health by providing culturally sensitive, integrated primary and preventive care to all, regardless of ability to pay or immigration status, and by collaborating with community partners to address social determinants of health.

Requirements

High school diploma or GED.
At least one year of work or volunteer experience in a customer service job or internship.
Bilingual Spanish/English proficiency.
Current Basic Life Support certification.
Current California driver’s license and ability to travel between clinics.
Ability to understand and carry out oral and written instructions, maintain complex records and files, and deal effectively with the public.
Ability to work under pressure and efficiently manage multiple tasks and priorities.
Excellent customer service skills and a professional demeanor.
Ability to communicate tactfully and effectively, orally and in writing.
Ability to work effectively with multicultural and economically diverse populations and with clients regardless of race, immigration, housing, or financial status.
Mature judgment and compliance with HIPAA, audit requirements, and other regulations in a highly confidential position.
Commitment to support and implement RFHN’s philosophy, goals, and objectives.

Nice To Haves

Experience in a healthcare setting as a Certified Enrollment Counselor.
Knowledge of business office procedures.
Proficiency with Microsoft Office and electronic health records; Epic experience preferred.
Up-to-date COVID-19 vaccination per current CDC guidelines is strongly recommended.

Responsibilities

Become a Certified Enrollment Counselor through the State of California and complete Community Health Advocate training through County partners.
Assist applicants in gathering verification documents required for Federal, State, and County community program applications.
Enter application information in the appropriate software systems.
Screen and refer Gateway well child visits to determine whether uninsured children are eligible for coverage.
Collaborate with health coverage partners in San Mateo and Santa Clara Counties and community-based organization partners to improve program service delivery.
Participate in County partner coalitions and regional health outreach meetings concerning outreach barriers, best practices, retention strategies, and eligibility processing.
Conduct community and interagency presentations about healthcare insurance and County coverage programs.
Participate in community health events to inform and screen uninsured families for Medi-Cal, Kaiser Health Plans, ACE, PCAP, Covered California, and RFHN’s Sliding Fee Scale.
Respond to internal staff questions and requests about eligibility and enrollment.
Review applications monthly to determine whether cases are pending, approved, or denied.
Inform and educate applicants about coverage payments and details, and provide insurance plan billing and payment information.
Conduct telephone enrollments and home visits when needed.
Link enrollment platform information to RFHN’s Epic system.
Register new patients and re-register established patients by entering demographic information, printing registration forms, obtaining signed Consent for Treatment Statements, and filing forms in medical records.
Collect Power of Attorney, Guardianship, Emancipation, Asylum, and other legal forms related to identity or patient care.
Maintain patient confidentiality at all times.
Help patients navigate other internal and external services as needed.
Provide consistent and accurate case management with minimal supervision, including charting, referrals, follow-ups, and eligibility and enrollment information.
Greet patients and visitors promptly, courteously, and helpfully.
Answer telephones, provide information, screen calls, take messages, and direct calls to the appropriate person.
Screen visitors and respond to routine information requests.
Keep the work area neat and orderly.
Float to cover CHA duties at Ravenswood and MayView campuses and cover the CHA Front Desk at Ravenswood when needed.
Perform other duties as assigned and requested.