Eligibility Specialist III - MISP

Bilingual Eligibility Specialist III

Riverside University Health System (RUHS) Medically Indigent Services Program (MISP) is currently recruiting to fill a Bilingual Eligibility Specialist III. The incumbent will support the Medically Indigent Services Program in Moreno Valley and may travel to various locations throughout Riverside County.

The Bilingual Eligibility Specialist III plays a key role in performing comprehensive insurance verification, cost estimation, financial assistance screening, and meticulous record keeping across the Medical Center's inpatient, emergency room, outpatient, and MSC Lead areas. This position provides essential support to departments including the Emergency Department, Inpatient units, Outpatient MISP Team, Case Management, Admitting, and other operational areas. The specialist conducts face-to-face patient screenings and onsite interviews, including bedside assessments for programs such as Medi-Cal, Hospital Presumptive Eligibility, Newborn Gateway, MCIEP for inmates, MISP, and Financial Assistance/Charity Care, while auditing daily application intake and program screenings for accuracy. Responsibilities include verifying insurance eligibility, benefits, and pre-authorizations prior to services, supervising complex eligibility issues, training and developing Eligibility Specialists and other staff, and coordinating procedural updates resulting from changes in state, county, or federal regulations, including the preparation and maintenance of office procedure manuals.

Schedule: Monday through Friday - 8:00 AM - 4:30 PM Location: 26520 Cactus Ave. Moreno Valley CA 92555 Bilingual: Spanish/English, Levels I & II required

Under supervision, determines initial and continuing eligibility for one or more public social service aids or medical assistance programs in accordance with established procedures; performs complex and specialized eligibility work such as quality control and quality assurance of previously processed aid applications or the review, evaluation, investigation, and justification of eligibility determinations that have been appealed by clients; refers applicants and recipients who appear to be in need of social services to the appropriate staff members; performs other related duties as required. The Eligibility Specialist III is the advanced working level in the Eligibility Specialist series. The Eligibility Specialist III is distinguished from the Eligibility Specialist II by assignments, which require an advanced knowledge of the eligibility determination process. This may include auditing work of the Eligibility Specialist I and II levels, working with preventive fraud or serving in a lead capacity over subordinate staff to coordinate and assign work and assist the supervisor in preparing reports and evaluating and training staff.

Meet the Team! Founded in 1893, Riverside University Health System Medical Center has grown into a cornerstone of healthcare excellence and medical education in the region. Our highly skilled healthcare professionals and dedicated support staff are committed to delivering exceptional, state-of-the-art care to the diverse populations of Riverside County.

Located in Moreno Valley, our 439-bed Medical Center is home to a Level I Trauma Center, a Level II Pediatric Trauma Center, and the county's only Pediatric Intensive Care Unit (PICU). If you're passionate about making a meaningful difference and helping others, RUHS Medical Center is the place for you!