Enrollment Specialist

Job Description

Job Description

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. They will also assist with any questions the patient may have in regards to the insurances accepted at the clinic. The Enrollment Specialist will make follow up calls to patients if they are missing any information in their application and will ensure to input all patient information into the Electronic Health Records. Must currently be or willing to become an Enrollment Specialist to assist patients with insurance enrollment.

ESSENTIAL DUTIES AND RESPONSIBILITIES include but are not limited to the following functions:

• Provides patients with educational information on manage care both in the clinic and in the community, formally or informally,

• Screens patients to Identify enrollment eligibility schedules appointments for initial enrollment.

• Enroll patients in Covered California marketplace.

• Retention list Contact cash patients and screen them and also disenrolled members, identifying the reasons for disenrollment, assisting with re-enrollment.

• Enroll patients into Cal-Fresh or assist with Cal-Fresh renewals -SAR 7

• Assist patients to submit health options and medical choice forms.

• Call health plan for Primary Care Physician (PCP) changes.

• Educate and advise patients on available insurance and plans.

• Provide assistance to patients for transportation through their health insurance and translating services.

• Conduct outreach to increase the patient's roster.

• Submit weekly reports regarding enrollments completed.

• Assist 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. Requirements listed below are representative of the knowledge, skill and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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.

• Bilingual Spanish speaking preferred.

• 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.

Policy

Punctual and regular attendance is an essential responsibility of each employee at CNHF. Employees are expected to report to work as scheduled, on time and prepared to start working. Employees also are expected to remain at work for their entire work schedule. Late arrival, early departure or other absences from scheduled hours are disruptive and must be avoided.

This policy does not apply to absences covered by the Family and Medical Leave Act (FMLA) or leave provided as a reasonable accommodation under the Americans with Disabilities Act (ADA). These exceptions are described in separate policies.

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).

1. AGREEMENT AND ACCEPTANCE

2. I HAVE READ THE ABOVE JOB DESCRIPTION AND FULLY UNDERSTAND THE REQUIREMENTS SET FORTH AND WILL PERFORM ALL DUTIES AND RESPONSIBILITIES TO THE BEST OF MY ABILITY.