Medical Admin Specialist (Empanelment)

Clinica Romero•Los Angeles, CA

31d

About The Position

The Empanelment Clerk works closely with the PCMH Manager to ensure the implementation, maintenance, and sustainability of Empanelment. The Empanelment Clerk is responsible for assisting with chart reviews to update the Primary Care Providers to ensure that the proper provider/care team is assigned to individual patients. Additionally, this role is responsible to run eligibility verifications throughout the varies portals needed to identify the patient’s eligibility and enrollment status. Individual must also be flexible, organized and must be able to manage a demanding workload with accuracy. In addition, supports Clinica’s mission and complies with all policies and procedures.

Requirements

High School Diploma or Equivalent
1-2 years of experience in healthcare, medical office setting preferred.
1-2 years of experience with running/looking up patient insurance eligibility verifications.
Strong verbal and written communication skills, English/Spanish
Strong computer skills
Typing at least 25 wpm.
Must have strong customer-service orientation.
Must have strong team orientation.
Ability to handle multiple tasks and work in a busy environment.
Knowledge of Federally Qualified Health Centers.
Previous experience with electronic health records (EPIC preferred).
Proficient with Microsoft Office suite or related software.
Organized, flexible, thoroughness, dependability and attention to
Able to work and communicate effectively with people of diverse culture.

Responsibilities

Works with the PCMH Manager on assigned patient lists to review and assign current Primary Care Providers (PCP) to ensure that each patient is empaneled to a PCP.
Reviews individual provider lists to ensure that each patient has their current PCP listed in the PCP field of the EHR chart. Updating each individual chart as needed.
In addition, reviewing the patients assigned Primary Location in their chart to reconcile with current PCP and the PCP current clinic site.
Maintains familiarity with various types of Medi-Cal, Health Plans and other programs.
Responsible for reviewing and verifying patient eligibility and enrollment status for all Medi-Cal/ Manage Care patients and other programs by utilizing the appropriate web portals. Eligibility must be verified accordingly with all associated coverages.
Adds notes in patients’ chart in the efforts to collaborate with other departments to ensure charts are properly updated.
Works with the Front Office departments at all clinic sites as needed to ensure patients preference on assigned PCP and Primary Location.
Utilizes Microsoft Outlook for all incoming emails, confirms and timely responds to emails from Manager and other departments.
Communicates well with Manager on assigned tasks to ensure that they are completed.
Demonstrate a positive, can do attitude in responding to employee and patients’ needs.
Responsible for other duties or additional task(s) as assigned to by the PCMH Manager or other upper management team.