An Eligibility Specialist provides assistance and information for people who apply for a government benefits program or health care program. Answers questions, assists with an application process, and reviews applications and relevant background information to determine eligibility. May assist eligible applicants with enrolling in a program.
Referral Specialist -(Bilingual-Fluent in Both English & Haitian Creole) Miracle of Love, Inc. Orlando, FL Job Details Full-time From $37,000 a year 21 hours ago Benefits Health insurance Dental insurance Paid time off Employee assistance program Vision insurance Retirement plan Qualifications Record keeping Customer communication Caregiving documentation requirements Medicare Writing skills Client rapport building Client file management Care documentation English Quality management High school diploma or GED Haitian Creole Direct support Managing patient records Full Job Description Position Summary The Referral Specialist for Ryan White department directs a client to needed core medical or support services in person or through telephone, written, or other type of communication. This service may include referrals to assist eligible clients to obtain access to other public and private programs for which they may be eligible (e.g., Medicaid, Medicare Part D, State Pharmacy Assistance Programs, Pharmaceutical Manufacturer's Patient Assistance Programs, and other state or local health care and support services, or health insurance Marketplace plans).
Key Referral Specialist activities include:
Complete Referral Determination Assessment (RDA) to determine client level of coordinated care. Communicate with clients 30 days prior to eligibility expiring and documenting all attempts. Refer client to EIS if client has fail to communicate after three attempts. Facilitate referral to oral health, transportation and nutrition Track referrals to other core medical, support services, and partner services. Provide education to clients regarding available benefits programs, assist with applications, provide advocacy with appeals and denials, assist with recertification and provide advocacy in other areas relevant to maintain benefits/resources. Document all consumer progress and contacts in progress notes within 48 hours of contact. Maintains all required and appropriate documentation for client records and progress notes for assigned cases in accordance with Miracle of Love, Inc. policy and procedures and Orange County Board of County Commissioners requirements. Meets services productivity (direct client services) standard of 30 units per day for the provision of Referral Specialist services in accordance with applicable quality criteria, which are supported by appropriate record documentation, which meet specifications, documentation, requirements with Miracle of Love's standards. Implements quality management (QM) standards based on the Clinical Quality Management (CQM) plan. Review, revise, and update errors in Provide Enterprise (PE) from the QM task form to ensure QM deliverables are met.
Essential Skills and Experience:
• Bilingual - Fluent in English and Haitian Creole • Clean criminal history Ability to be an active listener to others and to establish and maintain effective working relationships while demonstrating understanding, patience and tact in dealing with clients, personnel and the general public. Demonstrate leadership qualities and the ability to plan, organize and coordinate work assignments. Ability to communicate effectively verbally and in writing. Ability to establish and maintain relationships, empathizes, and communicates with clients and family members. Ability to maintain complete and up-to-date record documentation Physical demands and work environment Physical demands: While performing the duties of this job, the employee is occasionally required to walk, sit; use hands to fingers, handle or feel objects tools, or controls; reach with hands and arms; balance; stoop; talk or hear. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities required by the job included close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. Physical or mental ability to carry out the activities of position responsibilities.
Work environment:
While performing the duties of the job, the employee is exposed to bodily fluids, weather conditions prevalent at the time of duty. The noise level is usually minimal to moderate.
Job Type:
Full-time Pay:
From $37,000.00 per year
Benefits:
Dental insurance Employee assistance program Health insurance Paid time off Retirement plan Vision insurance Application Question(s): What is your expected salary?
