Eligibility Specialist

ADELANTE HEALTHCARE INC•Peoria, AZ

1d•Onsite

About The Position

The Eligibility Specialist is responsible for promoting health insurance programs through coordinated comprehensive and effective outreach efforts. Will greet incoming patients/clients, screen for medical coverage eligibility available through different programs and assist with the application process, register patients, and provide information regarding Adelante Healthcare, Inc. Will attend outreach events and promote Adelante Healthcare services. Work is performed under the direct supervision of the Eligibility Manager at each site. EXPECTATIONS Every Adelante Healthcare employee will strive to maximize their performance and contribution to Adelante Healthcare and the community we serve every day. Employees are expected to work in a manner that demonstrates a commitment to quality, patient safety, employee engagement, innovation, and the highest standards of personal integrity, professionalism, and competence. OUR CORE VALUES Inclusion Nurture Service Purposeful Integrity Resilient Engaged

Requirements

Certification to perform cardiopulmonary Resuscitation for the Health Care Professional (CPR) and AED through courses that follow the guidelines from the American Heart Association and Red Cross (cognitive and skills evaluations)
Valid Level One Fingerprint Clearance Card issued by the Arizona Department of Public Safety for all specialty behavioral health locations
High School Diploma or GED from an accredited institution
Minimum one (1) year experience in medical front office, customer service and/or experience in sales, interview techniques, and extensive public relations/contact work
Experience and knowledge of health care programs available through state and federal programs such as Medicaid/AHCCCS, DES, etc.
Bilingual English/Spanish. Must have the ability to communicate effectively with monolingual Spanish speakers
Ability to write routine reports and correspondence, utilizing excellent English, spelling, and punctuation skills
Ability to calculate figures and amounts such as discounts, interest, and percentages
Ability to interpret a variety of instructions furnished
Strong familiarity with human service agencies serving low-income and minority populations and understanding of and sensitivity to issues of concerns to low-income and minority communities
Ability to meet and deal effectively with clients, associates, and the general public
Basic computer efficiency, with the ability to utilize the Patient Management system
Valid AZ driver’s license
Ability to drive to any of our locations and other areas in Maricopa County to cover at other sites and provide outreach.
Competency in dealing with people of various cultures and backgrounds

Nice To Haves

Associates Degree from a two year college in a health care or related field
Three (3) years of experience in community health

Responsibilities

Welcome patients and provide information on health care programs.
Greet patients/clients, screen for appropriate medical coverage eligibility available through state programs, and assist patient/client in application process for medical programs, track applications in progress for completion by continued contact with patient/client and assist patient/client with problem application
Register patient/client with Adelante’s health center for primary health care and promote and register patient/client for other available programs within Adelante’s facility
Assure patients are registered under correct eligibility and corresponding pay code.
Accurately update patient records accordingly for eligibility. Maintain current status of work in progress with accuracy and productivity at measured benchmarks
Guide and assist patients/clients in utilizing recommended services as indicated by medical referral and make appropriate referrals to community agencies on a case by case basis. Orient patients/clients to care delivery system and available resources.
Share pertinent information regarding health programs
Drive to various locations in Maricopa County, including, but not limited to, other Adelante Healthcare facilities to provide outreach and eligibility services
Present to other community partners on what services Adelante Healthcare offers
Attend community outreach events to promote Adelante Healthcare services