Eligibility Manager

Job Description

Job Description

FamilyCare Health Centers is looking for an Eligibility and Enrollment Manager based in our Teays Valley location.

Physical Requirements:

The employee is regularly required to talk and hear. The employee is regularly required to sit, stand, and walk. The employee must frequently lift/and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. The employee must occasionally bend and stoop. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to focus.

Qualifications:

High School Graduate or equivalent. Excellent verbal skills and the ability to work with a variety of people of various backgrounds. Organizational skills essential. Basic knowledge of computer and medical terminology necessary.

Basic Function:

Manage the Eligibility Enrollment Specialist. Provide screening and eligibility assistance to FamilyCare patients and the community.

Duties and Responsibilities:

• Manage and assist the Certified Application Counselors with CAP/SFS, screenings for Marketplace, Medicaid, Medicare, phone calls, and events.
• Screen and assist patients with enrollment into available programs including; Sliding Fee (SFS), Community Access Program (CAP), Children's Health Insurance Program (CHIP), Medicaid/Medicare, and The Marketplace.
• Identify other patient and family needs, such as where and how to obtain eye glasses, dental treatment, clothing, housing, and various educational programs,
• Maintain a close working relationship with Department of Health and Human Resources (DHHR) and other community organizations.
• Distribute information and materials regarding services to community and local business.
• Participate in events, health fairs, and other activities as a representative of FamilyCare as needed.
• Track and maintain current income and program requirements needed to determine eligibility for services.
• Provide statistics and enrollment data, as needed.
• Report on tracking to the Primary Care Association and Director of FamilyCare.
• Deliver completed forms to DHHR and other agencies in timely manner..
• Follow-up and meet with patients to clarify and assist them with the completion of applications.
• Make calls to patients on Medicare to see if we can get them enrolled with Medicaid as a secondary insurance to absorb some of the cost.
• Assist patients when applying through the Marketplace. If it is a Special Enrollment Period, assist the patient with proper documentation to validate the SEP and upload or provide correct mailing information.
• Call those patients who have recently lost their Medicaid or insurance to assist them with getting re-enrolled.
• Make calls to the Medication-Assisted Treatment Program patients to see if they are eligible for Medicaid enrollment.
• Call uninsured patients to let them know about the assistance programs that are offered at FamilyCare.