Medi-Cal Eligibility & Enrollment Specialist

Community Action Partnership of San Luis Obispo County, Inc. • San Luis Obispo, CA

1d

About The Position

Under the supervision of the Billing and Data Programs Supervisor, the Medi-Cal Eligibility & Enrollment Specialist is responsible for ensuring client Medi-Cal eligibility is maintained and tracked for all CAPSLO Homeless Services programs. This role regularly conducts eligibility checks, supports case managers and program staff with the completion and submission of authorization paperwork, and stays up to date on policy changes that impact client eligibility or service billing requirements. The position supports CAPSLO’s mission by maximizing clients’ access to Medi-Cal reimbursable services and assisting frontline staff with compliance-related administrative tasks that ensure continuity of care and funding.

Requirements

• Must have a combination of education and/or experience equivalent to a minimum of three years experience in homeless services.
• Must have knowledge of homeless services Case Management.
• Knowledge and experience with HMIS and Client Track systems.
• Valid Driver's License and auto insurance.

Nice To Haves

• Being fluent in two or more languages, including one that supports the needs of the program and community is preferred, not required.
• Experience in billing state-managed care plans preferred.
• Bachelor's Degree in Social Work, Policy and Administration, or related fields

Responsibilities

• Conducts regular Medi‑Cal eligibility checks for clients across CAPSLO Homeless Services programs, tracks changes, and coordinates timely follow‑up with Case Managers, County Social Services, and partner agencies to help clients maintain or regain coverage.
• Supports staff (including Case Managers, Clinicians, and Peer Specialists) by assisting with required forms and authorization paperwork, offering guidance on documentation requirements, and keeping reference materials current by role and program.
• Monitors Medi‑Cal and CalAIM policy updates, translates changes into practical workflow adjustments, and communicates updates through procedures, workflows, and staff training.
• Acts as a liaison between direct service teams and billing/data staff to ensure documentation aligns with billing requirements, helps troubleshoot recurring documentation issues, and contributes to internal planning related to Medi‑Cal services.
• Maintains accurate eligibility and documentation records, ensures confidentiality and HIPAA compliance, and supports internal audits and external review preparation.
• Demonstrates commitment to CAPSLO’s mission, follows all safety practices, and performs additional duties as needed.

What This Job Offers

• Job Type: Full-time