Eligibility Specialist

Job Title Eligibility Specialist Classification Full Time / Non-Exempt Reports to Front Office Manager Rate $15-18 per hour Summary Eligibility Specialist provides enrollment assistance for eligible health center patients into affordable health insurance coverage through the Health Insurance Marketplaces, Medicaid, and the Children’s Health Insurance program and determines patient’s eligibility to benefit from the clinic sliding fee scale. Individual will also be available to assist with screening individuals for CBWF’s Patient Ancillary Assistance Program (PAAP). Responsibilities Complete online training courses to become a Certified Application Specialist upon hire. Determine patient’s eligibility and assist in applying for health insurance through the Marketplace. Educate potential new patients on available services and assist in new patient enrollment. Complete sliding fee scale packet on patients to determine eligibility for service discounts. Maintain all appropriate documentation of patient’s eligibility, including financial documents, scan and place in patient folder, and update as required. Contact patients utilizing sliding fee scale to remind them to update eligibility packet and secure updated financial documents. Successfully complete internal trainings to include cultural competency, health literacy, and privacy and security standards. Verify patient demographic information. Communicate effectively in writing, including the preparation of administrative, technical and statistical reports. Additional Expectations Learn and utilize EMR. Serve as backup to front office and operator. All other duties as assigned. Requirements Certified Application Counselor- ACA Training or ability to become certified. Understanding of insurance and the marketplace. Experience in Children’s Health Insurance Program (CHIP) and Medicaid eligibility and enrollment. Preferred BA in social service field or marketing, experience may be substituted. Experience working in a clinic and/or social service organization. Working knowledge of eligibility verification and prior authorizations for payment from various HMOs, PPOs, commercial payers and other funding sources. Time/Physical Requirements Monday-Friday, 8:00am-5:00pm/40 hours per week. Some evening and weekend activities may require flexing schedule. Tasks occur in both medical office, clinic setting, and community. Able to lift 25lbs and perform normal duties associated in a clinic and office setting. #J-18808-Ljbffr