POSITION SUMMARY

California Benefits Support Center (CBS) is seeking a compassionate, detail-oriented, and highly organized Medical & Payment Assistance Enrollment Specialist to assist low-income and underserved individuals with access to healthcare coverage, medical financial assistance, prescription assistance, and other supportive benefits. The Enrollment Specialist will serve as a primary point of contact for individuals seeking assistance through CBS programs, including the Healthcare Access Program (HAP), Medi-Cal, and related healthcare and benefits programs . This position will conduct client intake and screening, determine potential eligibility, collect and verify documentation, assist clients with enrollment and applications, process medical assistance requests, coordinate supporting documentation, communicate with healthcare providers and insurers, track claims and payments, and provide ongoing follow-up. The ideal candidate will be comfortable working with sensitive medical and financial information and will demonstrate exceptional attention to detail, compassion, confidentiality, and follow-through.

ABOUT CALIFORNIA BENEFITS SUPPORT CENTER

California Benefits Support Center is a 501(c)(3) nonprofit organization whose mission is to empower vulnerable Californians—particularly seniors and low-income individuals—through compassionate support, direct financial assistance, and guidance accessing healthcare, housing, and essential benefits. CBS focuses on health equity, benefits access, financial assistance, community outreach, and advocacy for underserved populations.

PRIMARY RESPONSIBILITIES 1.

Client Intake & Enrollment

• Serve as an initial point of contact for clients seeking assistance.
• Respond to telephone, email, online, and in-person inquiries.
• Conduct client intake and needs assessments.
• Explain CBS programs and eligibility requirements.
• Screen clients for potential eligibility.
• Assist clients in completing registration and referral forms.
• Collect required client documentation.
• Review applications for completeness and accuracy.
• Identify missing or inconsistent information.
• Follow up with clients to obtain missing documentation.
• Maintain organized electronic client files. 2. Healthcare Access Program Enrollment Assist eligible clients with the Healthcare Access Program, including:
• Initial eligibility screening.
• Household and income verification.
• Review of medical and healthcare needs.
• Collection of medical bills and supporting documentation.
• Verification of insurance information.
• Review of prescription-related expenses.
• Review of medical, hospital, pharmacy, and insurance-related claims.
• Preparation of applications for program review.
• Communication with clients regarding application status.
• Follow-up regarding missing information.
• Documentation of approval or denial decisions.
• Communication of program requirements to clients. CBS's HAP program currently provides financial assistance for eligible medical and prescription expenses and may make approved payments directly to healthcare providers, pharmacies, or insurance providers. 3. Medical Bill & Payment Assistance
• Receive and review medical assistance requests.
• Review bills, invoices, insurance statements, payment coupons, and other supporting documents.
• Determine whether submitted documentation is complete for program review.
• Verify provider, pharmacy, insurance, and payment information.
• Coordinate with healthcare providers and pharmacies regarding outstanding balances.
• Communicate with insurance companies regarding eligible expenses.
• Track payment requests from submission through resolution.
• Maintain accurate payment-assistance records.
• Document all client and provider communications.
• Follow up on unpaid or unresolved claims.
• Escalate unusual or complex payment situations to the Program Manager. CBS's current procedures require supporting documentation for medical insurance payment requests and allow approved payments to be made to insurance companies and, depending on the assistance, healthcare providers and pharmacies. 4. Medical Expense Documentation Assist clients in gathering:
• Medical bills.
• Hospital bills.
• Pharmacy bills.
• Prescription information.
• Insurance statements.
• Explanation of Benefits (EOBs).
• Insurance cards.
• Medicare information.
• Provider information.
• Proof of income.
• Proof of residency.
• Household information.
• Other documentation required by the program. Review documents for accuracy, completeness, and consistency. 5. Medi-Cal Enrollment
• Conduct preliminary Medi-Cal eligibility screenings.
• Assist clients with Medi-Cal applications.
• Explain the basic enrollment process.
• Assist clients with gathering required documentation.
• Assist clients with online and/or telephone applications.
• Follow up on pending applications.
• Assist with renewals and recertifications.
• Help clients understand notices and requests for information.
• Refer complex eligibility issues to appropriate resources or the Program Manager. CBS currently provides free Medi-Cal enrollment assistance through trained enrollment advocates. 6. Client Advocacy & Navigation
• Help clients understand healthcare and benefits systems.
• Explain notices and program correspondence in understandable language.
• Help clients identify appropriate resources.
• Assist clients in resolving administrative barriers.
• Make referrals to healthcare, social service, housing, food, transportation, and other community resources.
• Advocate for clients when appropriate within the organization's scope.
• Maintain a compassionate, respectful, and client-centered approach. 7. Provider & Partner Communication Communicate professionally with:
• Physicians.
• Medical offices.
• Hospitals.
• Pharmacies.
• Insurance companies.
• Medicare-related providers.
• Case managers.
• Social workers.
• Community organizations.
• Government agencies.
• Other referral partners. Obtain information necessary to process applications and payment assistance requests. 8. Data Management & Documentation
• Enter client information into approved databases.
• Maintain accurate electronic records.
• Track applications and claims.
• Track payment assistance requests.
• Track approvals and denials.
• Maintain follow-up schedules.
• Document all client interactions.
• Maintain confidential medical and financial information.
• Prepare information needed for program reports. 9. Outreach Support
• Participate in community outreach activities.
• Attend health fairs and community events.
• Present information about CBS programs.
• Distribute outreach materials.
• Develop relationships with referral organizations.
• Identify individuals who may benefit from CBS programs.
• Assist with community enrollment events. 10. Quality Assurance
• Review applications for completeness before submission.
• Identify documentation errors.
• Follow established program procedures.
• Maintain accurate case notes.
• Protect confidential information.
• Participate in quality-control reviews.
• Report potential compliance issues to the Program Manager.
• Maintain professional standards in all client interactions.

REQUIRED QUALIFICATIONS

• High school diploma or equivalent required.
• Associate's or Bachelor's degree preferred.
• At least 1-2 years of experience in healthcare, social services, benefits enrollment, medical billing, case management, nonprofit services, insurance, or a related field.
• Strong computer skills.
• Strong attention to detail.
• Excellent verbal and written communication.
• Ability to handle confidential information.
• Ability to work with individuals experiencing financial hardship.
• Strong organizational and follow-up skills.
• Ability to manage multiple cases simultaneously.
• Ability to work independently and as part of a small team.

PREFERRED QUALIFICATIONS

• Experience with Medi-Cal.
• Experience with medical financial assistance.
• Experience with medical billing or insurance.
• Experience reviewing medical bills or EOBs.
• Experience working with hospitals, pharmacies, physicians, or insurance companies.
• Experience with Medicare.
• Community Health Worker experience or certification.
• Bilingual English/Spanish.
• Experience working with seniors and individuals with chronic or complex healthcare needs.
• Experience working with underserved populations.

CORE COMPETENCIES

• Client advocacy
• Benefits navigation
• Healthcare navigation
• Medical financial assistance
• Documentation
• Data entry
• Case management
• Communication
• Confidentiality
• Problem solving
• Attention to detail
• Follow-through
• Cultural competency
• Customer service
• Organization

PERFORMANCE MEASURES

The Enrollment Specialist will be evaluated based on:

• Number of clients screened.
• Number of completed applications.
• Successful benefit enrollments.
• Medical assistance applications processed.
• Payment requests processed.
• Accuracy of client documentation.
• Timeliness of follow-up.
• Client satisfaction.
• Quality and completeness of case records.
• Compliance with organizational procedures.
• Successful referrals and community outreach activities.

IDEAL CANDIDATE

The ideal candidate is compassionate but highly detail-oriented. This person should be comfortable saying: "Let me find out what is preventing this client from receiving care, what documentation is needed, who needs to be contacted, and what we need to do next." The candidate must be persistent because many clients will require multiple follow-ups before their healthcare or financial assistance issue is resolved.

CONFIDENTIALITY

Because this position will handle sensitive medical, financial, insurance, and personal information, the employee must maintain strict confidentiality and comply with applicable organizational privacy and information-security requirements.

EQUAL OPPORTUNITY

California Benefits Support Center is an equal opportunity employer committed to maintaining a diverse, inclusive, respectful, and supportive workplace.

DISCLAIMER

This job description describes the general responsibilities and qualifications of the position and is not intended to be an exhaustive list of all duties. Responsibilities may be modified as organizational and program needs change.

Pay:

$24.00 per hour Expected hours: 20.0 per week

Work Location:

In person