Eligibility Specialist
Company: San Ysidro Health Center
Location: National City
Posted on: March 16, 2023
Job Description:
Position Summary:
Under the supervision of the Eligibility Department Supervisor, the
Eligibility Specialist II will provide clinic in-reach, eligibility
education, enrollment navigation and retention assistance aimed at
support individuals/families in obtaining and retaining health care
coverage.
Essential Functions of the Job:
- Assists individuals and families in applying for and retaining
health coverage by collecting required and accurate personal and
demographic information; determining eligibility; assessing needs;
providing accurate information regarding health coverage options;
uploading/submitting verification documents and completing
applications.
- Complete and submit health coverage applications, presumptive
eligibility applications, and gateway applications. Initiate and
maintain proper follow-up with patient and government agency to
ensure timely processing and completion of all mandated
applications and accompanying documentation.
- Monitors and initiates health coverage redetermination/renewal
process for patients. Completes Medi-Cal Renewal Package, CCA
Renewal Process, Reports all changes on active accounts, Medi-Cal
Add-Ons, New Born Referrals.
- Facilitates referral to SYH and community resources for
assistance with other needs and intricate issues.
- Maintains accurate and thorough records of all activities.
Prepares statistical reports and patient/client correspondence.
Submit monthly report by the 1st of every month.
- Provides responsive, high quality service to patients, SYH
employees, representative of County and outside agencies and
members of the public by providing accurate, complete and
up-to-date information in a courteous, efficient and timely
manner.
- Provide follow-up activities as needed to ensure families
obtain and retain health coverage. A high focus will be on
assisting high-acuity patients requiring more intensive assistance
(i.e. senior, child or adult with disability) to ensure there is no
lapse in coverage.
- Conducts clinic in-reach and education activities, individually
and in group, to SYH patients and community members at clinic
locations and other community locations about SYH services and
programs, public health assistance programs, health insurance
options, voter information/registration and policy issues impacting
the community. Submits clinic in-reach report by the 27th of each
month.
- Supports Eligibility Supervisor with on-site training for new
staff when requested. Following proper procedures and training
templates provided by Eligibility Supervisor. Additional Duties and
Responsibilities:
- Complies with all department, organization and government
policies & procedures.
- Attends meetings and trainings as required.
- Provides CES coverage as needed.
- Performs other related duties as assigned or requested. Job
Requirements:
Education Required: High School Diploma or GED equivalent
required.
Preferred: Bachelor Degree in a health or human service field.
Certifications/Licenses:
Reliable transportation
Must pass the Covered California criminal background check and two
exams
1) Certified Enrollment Counselor (CEC) exam
2) SYH Eligibility Competency Exam within the 90-day probationary
period.
Experience and Required Skills:
- A minimum of one year of experience performing eligibility
insurance or billing experience.
- Related education may substitute for experience. Verbal and
Written Skills to Perform the Job:
- Must have excellent oral and written communication skills.
Technical Knowledge and Skills to Perform the Job:
- Knowledge of local, state and federal public health assistance
programs and respective policies and regulations.
- Proficient in Microsoft applications and use of electronic
health data systems including NextGen, CalWin, CalHEERS.
- At a minimum, have good computer/tablet literacy including
internet navigation and research skill. About UsSan Ysidro Health
is a Federally Qualified Health Care organization committed to
providing high quality, compassionate, accessible and affordable
healthcare services for the entire family. The organization was
founded by seven women in search ofmedical services for their
families and community. Almost 50 years later, SanYsidro Health now
provides innovative care to over 108,000 patients through avast and
integrated network of 47 program sites across the county. San
YsidroHealth could not serve our patients without the dedication of
our passionateand hardworking employees. Apply today and become a
part of our mission-driven team!San Ysidro Health has a
long-standing commitment to equal employment opportunity for all
applicants for employment. Employment decisions including, but not
limited to, those such as employee selection, performance
evaluation, administration of benefits, working conditions,
employee programs, transfers, position changes, training,
disciplinary action, compensation, and separations are made without
regard to race, color, religion (including religious dress and
grooming), creed, national origin, nationality, citizenship status,
domestic partnership status, ancestry, gender, affectional or
sexual orientation, gender identity or expression, marital status,
civil union status, family status, age, mental or physical
disability (including AIDS or HIV-related status), atypical
heredity cellular or blood trait of an individual, genetic
information or refusal to submit to a genetic test or make
available the results of a genetic test, military status, veteran
status, or any other characteristic protected by applicable
federal, state, or local laws.
Other details
- Pay Type Hourly
- Min Hiring Rate $17.31
- Max Hiring Rate $25.96
Apply Now
Keywords: San Ysidro Health Center, National City , Eligibility Specialist, Other , National City, California
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