Eligibility & Enrollment Specialist
IndianHealth Center of Santa Clara Valley•San Jose, CA
•Onsite
About The Position
This position is responsible for helping clients enroll in health insurance programs; registering new and established patients in IHC services; conducting outreach to established clients at the Indian Health Center (IHC); assisting patients develop payment plans; and backing up the front desk. The IHC is a Patient Centered Health Home and all employees are an integral part of this model of care delivery.
Requirements
- 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. Will need to provide this at time of hire
- 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
Nice To Haves
- Bi-lingual in Spanish preferred
Responsibilities
- Meet with new and established medical clients to inform them about the services offered at the IHC and to enroll them into health insurance programs or any available County coverage
- Greet patients in waiting room and help them to complete forms
- Conduct outreach calls to all of the IHC’s American Indian clients and encourage them to come in and receive services
- Conduct outreach calls and mailings to new medical managed care enrollees
- Create an incentive system aimed at reducing the number of no show clients
- Provide back up to the receptionist and medical records when needed
- Develop payment plans if needed for clients
- Compile monthly statistics for the Medical Department’s Board Report
- Prepare the Eligibility report for registration
- Make new patient registration packets
- Confirm appointments
- Check voicemail daily, follow up with calls and make new patient appointments
- Maintain schedule for Medi-Cal eligibility worker
- Assist patients with Medi-Cal applications
- Assist eligible applicants with the Covered California enrollment process
- Attend outreach events as needed
- Participate as a proactive representative of the Patient Centered Health Home
- Perform duties utilizing the Team-Based Approach
- Perform other duties as assigned
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
