Sr. Clinic Eligibility Coordinator (DHWC)

Sr. Eligibility Coordinator

The Sr. Eligibility Coordinator serves as a key ambassador for patient experience within the Clinic Eligibility Department, ensuring a welcoming and professional environment while managing high patient volumes and shifting priorities. Responsibilities include conducting daily high-volume eligibility inbound call screenings related to program eligibility, in person eligibility interviews, verifying financial and insurance information, and coordinating access to medical, dental, and behavioral health services providing high-quality patient-centered customer service.

This role is responsible for assisting established patients with inquiries related to registration, appointments, and general services, while also screening prospective patients and clients for eligibility across medical, dental, and case management programs for Methodist Healthcare Ministries (MHM).

The position requires strong leadership, organizational skills, and the ability to troubleshoot and support team members in real time, while maintaining accurate health records, training staff, and serving as a point of contact in the absence of leadership.

This role requires the ability to work maintain professionalism and composed demeanor while being responsible for high volume of incoming phone calls and in-person eligibility interviews. The ideal candidate communicates effectively in alignment with MHM core values. Demonstrates strong critical thinking skills and delivers an exceptional patient experience.

This role has a direct and meaningful impact on the overall patient experience within the Clinic Eligibility department. By ensuring a welcoming and professional environment, the position influences patient satisfaction and directly demonstrates MHM's core values by providing high-quality care. The role is critical in managing access to medical, dental, and behavioral health services, as well as connecting patients to external community resources, which supports equitable access to care for underserved populations.

This position requires analytical decision-making in evaluating patient eligibility and resolving intake-related issues. Works under established guidelines but exercises discretion when resolving patient/client/applicant eligibility concerns. Delegates task to clinic eligibility coordinators and is the acting point of contact when Clinic Eligibility Leadership is not available.

Internal: Collaborates daily with Clinic Eligibility team, organizational team members, support center, and leadership.

External: Regular interaction with patients, clients, program applicants and community resource partners. Communicates frequently in both English and Spanish.

Conduct clinic eligibility screenings and interviews through high-volume inbound and in-person eligibility interviews for medical, dental, and behavioral health services.

Obtains and evaluates required clinic eligibility documentation in accordance with MHM guidelines to determine program eligibility.

Apply critical thinking and sound judgment to evaluate patient/client/applicant needs and identify appropriate next steps for care and services.

Communicate eligibility requirements, eligibility determination and sliding-fee program discount if applicable professionally to patients/clients/applicants.

Schedules and coordinates patient/client/applicant appointments.

Assist patients with completing financial assistance applications, including Methodist Healthcare System Financial Assistance Program applications.

Review and process financial assistance documentation for completeness and accuracy.

Utilize department platforms, databases, and systems to support financial screenings and eligibility determinations.

Ensure eligibility determinations comply with applicable state and federal regulations and organizational policies.

Maintain accurate documentation to support eligibility determinations and patient account management.

Demonstrate strong attention to detail and accuracy when reviewing financial and eligibility information.

Apply AIDET communication standards to promote positive patient experience.

Conducts follow-up communication with patients and clients as needed.

Educate patients on available organizational services and resources.

Professionally manage and resolve patient concerns, questions, and inquiries using effective problem-solving and critical thinking skills.

Demonstrate strong verbal and written communication skills in interactions with patients, clients, and internal teams.

Maintain accurate and confidential patient records within Electronic Health Record (EHR) systems in compliance with HIPAA and organizational policies.

Document patient and client interactions accurately and timely within the EHR.

Update and maintain patient demographic, financial, and insurance information.

Maintain and apply sliding fee schedules in accordance with organizational guidelines.

Manage electronic and paper forms, ensuring required documentation is complete and properly maintained.

Review records for accuracy, completeness, and compliance with established standards.

Utilize office software, call center systems, and data entry applications to support daily operations.

Protect patient confidentiality and maintain compliance with HIPAA requirements and organizational policies.

Refer unqualified clients to internal or external services; share updated community resources with patients and team.

Manage appointment scheduling and rescheduling to support efficient patient access.

Monitor patient/client wait times and call queues to promote timely service and minimize delays.

Maintain an organized and professional workspace to support operational efficiency.

Work independently with limited supervision while maintaining established productivity and performance standards.

Meet or exceed department productivity, quality, and performance metrics.

Identify and resolve routine operational issues using effective problem-solving skills.

Demonstrate strong organizational skills, attention to detail, and the ability to manage multiple priorities in a fast-paced environment.

Perform additional administrative and operational duties as assigned.

This position does not supervise others.

Minimum Qualifications (Required)

• Education: High school diploma or GED
• Experience: Two years of scheduling experience within an Electronic Health Record (EHR) system.
• Other Required Skills/Knowledge:
  • Bilingual in English and Spanish
  • Basic proficiency in Microsoft Office Suite (Word, Excel, Outlook, MS Teams).

Preferred Qualifications

• Experience working with underserved populations.
• Familiarity with local, state, and federal healthcare and social service programs.
• Knowledge of financial assistance programs and application processes.
• Medical Assistant experience or clinical administrative background.
• Two years of call center in a healthcare setting.

Knowledge, Skills, and Abilities (KSAs)

• Strong verbal and written communication.
• Effective problem-solving and critical thinking.
• Ability to work independently and as part of a team.
• Professional and empathetic customer service demeanor.
• Attention to detail and organization.

Language Skills

• Bilingual in English and Spanish (required).
• Ability to read, write, and communicate clearly in both languages.

Technology and Tools

• Required: Electronic Health Records systems, Microsoft Word, Excel, Outlook,
• MS Teams, Smartsheet, SharePoint and S-Fax.
• General computer proficiency, including data entry and office technology.

Work Environment and Physical Demands

• Work Setting: Call center office environment.
• Physical Requirements: Frequent standing, sitting, bending, walking; occasional lifting up to 25 lbs.; use of step stools.
• Travel: 25%