Enrollment Specialist

INTRODUCTION Central Neighborhood Health Foundation is a Federally Qualified Healthcare Center (FQHC) committed to the Triple Aim as described by the Institute for Healthcare Improvement. Improving the US health care system requires simultaneous pursuit of three aims: 1) improving the experience of care, 2) improving the health of populations, and 3) reducing per capita costs of health care. Preconditions for this include the enrollment of an identified population, a commitment to universality for its members, and the existence of an organization (an "integrator") that accepts responsibility for all three aims for that population. SUMMARY The Enrollment Specialist will provide assistance with health insurance enrollment and Cal Fresh to patients, answer questions about the insurances accepted at the clinic, make follow‑up calls for missing information, and input all patient information into the Electronic Health Records. The specialist must currently be or be willing to become an Enrollment Specialist to assist patients with insurance enrollment. ESSENTIAL DUTIES AND RESPONSIBILITIES Provides patients with educational information on managed care both in the clinic and in the community, formally or informally. Screens patients to identify enrollment eligibility and schedules appointments for initial enrollment. Enrolls patients in Covered California marketplace. Contact cash patients for enrollment retention, screen them and also disenrolled members, identifying reasons for disenrollment and assisting with re‑enrollment. Enrolls patients into Cal‑Fresh or assists with Cal‑Fresh renewals. Assists patients to submit health options and medical choice forms. Calls health plan for Primary Care Physician (PCP) changes. Educates and advises patients on available insurance and plans. Provides assistance to patients for transportation through their health insurance and translating services. Conducts outreach to increase the patient roster. Submits weekly reports regarding enrollments completed. Assists patients with available resources regarding housing and/or employment in an effort to meet their specific needs. Performs other related duties as assigned. QUALIFICATION REQUIREMENTS To perform this job successfully an individual must be able to perform each essential duty satisfactorily. EDUCATION AND/OR EXPERIENCE High School Diploma or equivalent. CAA (Certified Application Assistor) Certification required. If the incumbent has no current CAA certification, it must be obtained within 6 months of hire. One year experience in a medical office is preferred. CPR Certification preferred. KNOWLEDGE, SKILLS, AND ABILITIES Ability to communicate effectively in both written and verbal form to patients, public, medical staff, and physicians. Must be or willing to become a Certified Enrollment Counselor. Knowledge of Electronic Health Records. Knowledge about health insurances. Excellent organizational skills and attention to detail. Ability to work independently and possess strong time management skills. WORK ENVIRONMENT Described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions. Variations in conditions may occur under certain circumstances. CONFIDENTIALITY Maintains patient, employee, and Foundation confidentiality at all times, discussing patient or employee business only with appropriate parties who have a bona fide need to know; and communicating only the minimum amount of information necessary with respect to protected health information (PHI) as defined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). #J-18808-Ljbffr