MEMBER SERV. ENROLLMENT & ELIG. COORDINATOR I

Company: North East Medical Services
Location: Daly City
Posted on: November 7, 2024

Job Description:

The Member Services Enrollment & Eligibility Coordinator I will perform patient registration, sliding scale assessment, eligibility screening, program enrollment and renewals. They will act as an advocate for the clients by assessing the health and social needs of the clients and refer their clients to appropriate programs.

ESSENTIAL JOB FUNCTIONS:

• Identifies and determines patient eligibility for NEMS sliding fee program, registers/informs clients for NEMS' service, obtains demographic information, assists in completion of applications and forms, and verifies insurance eligibility.
• Assists members in selecting or changing PCP according to established guidelines.
• Updates information and data in EPM as it occurs, i.e., changed of address, name, insurance coverage, etc.
• Acts as a point of contact when receiving complaints, assists with documenting complaints and forwarding the complaint for review.
• Assists with taking meeting minutes and notes.
• Identifies, assists, and enrolls patients for entitlement programs and updates patient information for Family PACT, Cancer Detection Program, CHDP, BCCTP, Healthy Kids and Healthy San Francisco.
• Provides one-on-one education on Health Care Reform; explains eligibility of programs, qualification standards, policy and procedure to prospective clients and members.
• Assists patients in resolving problems involving enrollment issues with Medi-Cal Covered CA insurance, and other health coverage programs.
• Completes all training programs and certifications as required; maintains an active Covered CA Certified Enrollment Counselor certification as required. Participates in training and meetings as appropriate.
• Provides other enabling services such as letter interpreting and form filling.
• Stays up to date on eligibility and changes for all public programs.
• Performs other job duties as required by supervisor. QUALIFICATIONS:
  • Must be detailed oriented, time management, multi-task, and work independently and in a group setting.
  • Strong interpersonal written and verbal skills.
  • Must be proficient in computers.
  • Completion of a four-year degree from an accredited university highly preferred. LANGUAGE:
    • Must be able to read, write and speak English fluently.
    • Must be verbally fluent in Spanish.
    • The ability to speak another language or dialect is highly desirable.
      
      STATUS:
      
      This is a FLSA Non-exempt position.
      This is not an OSHA high-risk position.
      
      NEMS is proud to be an Equal Opportunity Employer welcoming diversity in our workforce. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
      
      NEMS BENEFITS: Competitive benefits, including free medical, dental and vision insurance for employee, spouse and/or children; and company contribution to 401(k).

Keywords: North East Medical Services, Pittsburg , MEMBER SERV. ENROLLMENT & ELIG. COORDINATOR I, Other , Daly City, California