Enrollment Specialist I

APLA Health

121d • $25 - $28

About The Position

Under the direction of the Enrollment & Eligibility Manager, and in accordance with HRSA contract requirements, the Enrollment Specialist I assists clients, either directly or through referral, with enrollment/re-enrollment in Covered CA, Medi-Cal, Medicare, and MHLA, as well as with the process of accessing Public Benefits.

Requirements

• A high school diploma and 1 year experience in benefits enrollment.
• Must be trained as a Medi-Cal Enroller, Covered CA Certified Enrollment Counselor (CEC) and ADAP/OA HIPP/PrEP-AP Enroller or acquire these certifications within six (6) months of hire.
• Proficiency in writing, proofreading and grammar skills.
• Interpersonal customer service skills.
• Bilingual Spanish/English required.
• Knowledge of interviewing and assessment techniques; vocational rehabilitation and/or related occupational fields.
• Knowledge of word processing and eClinicalWorks electronic health records data entry.
• Comprehensive understanding of public benefits programs and policies; qualified health plans, including, but not limited to Covered CA, Medi-Cal, Medicare, My Health LA, and Ryan White.
• Knowledge of the healthcare field.

Responsibilities

• Screen clients using PointCare for eligibility in and assist with enrollment/re-enrollment in Covered CA, Medi-Cal, Medicare, MHLA, commercial products, Ryan White, ADAP, and PrEP-AP as well as with the process of accessing Public Benefits.
• Serve as the APLA Health & Wellness point of contact for addressing issues related to health plans that are part of independent physicians associations (IPAs) that APLAHW contracts with.
• Document contacts and maintain files, utilizing Point Care for enrollment allowing them to accurately qualify and enroll patients into coverage, faster.
• Stay current with APLA Health programs.
• Follow up to verify the status of enrollment applications and assist clients who are experiencing problems.
• Complete a comprehensive benefits and qualified health insurance assessment for each client.
• Maintain and update all client records via eClinicalWorks electronic health record system and review to verify and ensure data entered are accurate.
• Answer and respond to incoming telephone calls and emails regarding eligibility in qualified health plans and Public Benefits according to agency policy.
• Describe what a summary of benefits document is and where to locate a summary of benefits.
• Collaborate with other programs at APLA Health & Wellness and other service organizations to facilitate the provision of services.
• Maintain an extensive awareness of client resources, both agency-wide and Federally Qualified community based healthcare organization (FQHC).
• Prepare reports and client records as required to meet APLA Health & Wellness, city, state, and federal program requirements.
• Follow agency policies and maintain agency standards with regards to client confidentiality and HIPAA compliance.
• Effectively communicate with clients/patients in English and Spanish as required per aforementioned job duties.

Benefits

• Full Time position
• Salary Range: $25.60 - $28.82 Hourly
• Travel Percentage: Up to 25%
• Day Shift

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED
• Number of Employees: 101-250 employees