Find & Apply For Enrollment / Eligibility Specialist Jobs in Redwood Valley, California

Job Summary:

This position advocates and liaisons between Native Americans, non-Indian members of Indian households, and community resources to assist obtaining 3rd party resources for patients seeking services from CTHP. Job Duties & Responsibilities

• Assists patients in obtaining Medicare, Medi-Cal, CalFresh and Covered California Markeplace Insurance Coverage, available to the patients, and assists patients in completing paperwork properly for such resources.
• Provides patients with general information regarding eligibility requirements, application procedures, documentation requirements, renewal deadlines, and available resources.
• Assists patients in obtaining access to other agencies providing community services (i.e., Social Services, Social Security Administration, CalFresh, etc.).
• Maintains all in-house and outside referrals, contacts, and follow-up logs on all pending eligibility claims, including renewal activities.
• Assists with identifying alternate resource options with patients, including determining sliding fee scales, Medi-Cal, etc., based on family income.
• Uploads Medi-Cal and other related applications and verifications (back up documentation) to the Covered California and BenefitsCal online websites.
• Assists with resolving routine application or documentation issues and refers complex eligibility, enrollment, or coverage issues to the appropriate experienced staff member or supervisor.
• Works with internal departments by reviewing the daily patient schedules to determine if screening activities or additional follow up is needed while patient is onsite.
• Works closely with internal staff to identify patient needs for 3rd party resources.
• Documents patient contacts, eligibility activities, referrals, applications, renewals, and follow-up activities accurately and timely.
• May be designated to assist with weekly or monthly reporting activities.
• Assists with eligibility, enrollment, renewal, and redetermination tracking and reports as assigned.
• Supports all departmental records management needs, including filing, scanning, and faxing documents as needed.
• Prepares and maintains Medi-Cal Redetermination reports related to grant-funded activities using Excel and presents relevant information for Board review.
• Participates in training necessary to maintain current knowledge of applicable patient resource programs, enrollment systems, CTHP Policies and Procedures and mandatory trainings.
• Perform other duties as assigned. Minimum Qualifications (Education & Experience)
• High school diploma or equivalent, AND
• One (1) year experience working directly with clients providing information about social services programs (e.g., social security, Medicare, Medi-Cal, etc.).
• Current Covered California certified enrollment counselor (CEC), or ability to attain within the first six (6) months of employment.
• One (1) year experience using computers, specifically word processing and spreadsheet software.
• A combination of experience, education, and training may substitute for degree requirements on a year for year basis. Preferred Qualifications (Education & Experience)
• Associates degree in healthcare, business administration, or related field.
• Three (3) years of experience working directly with clients providing information about social services programs (e.g., social security, Medicare, Medi-Cal, etc.).
• Experience using electronic health records, eligibility systems, or web-based enrollment platforms.
• Indian Preference applies to all Consolidated Tribal Health Project (CTHP) positions in accordance with CTHP Policy and applicable federal law. Necessary Knowledge, Skills, and Abilities
• Knowledge of healthcare services and patient resources, and eligibility requirements for applicable programs and services.
• Strong understanding and sensitivity to American Indian/Tribal culture and lifestyle, working effectively with American Indian/Alaska Native populations.
• Ability to communicate effectively, both orally and in writing, regarding eligibility requirements, available resources, and alternative services while accommodating individual communication needs and demonstrating cultural awareness and sensitivity when working with American Indian/Alaska Native populations.
• Skills in operating personal computer using a variety of computer software.
• Ability to establish and maintain cooperative working relationships with management, coworkers, and outside contacts.
• Ability to maintain strict confidentiality and comply with all applicable federal and tribal privacy laws, as well as CTHP policy (HIPAA, HITECH, etc.).
• Ability to learn and apply program/agency operating policies and procedures.
• Ability to manage multiple priorities and tasks concurrently and meet deadlines.
• Ability to work independently as well as with teams.
• Ability to gather sensitive financial, household, insurance, identification, and other eligibility-related information in a professional and confidential manner.
• Ability to maintain accurate records and documentation and follow established procedures.
• Ability to recognize when a patient eligibility or enrollment matter requires assistance from a more experienced staff member or supervisor.

Working Conditions The physical demands 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 individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is frequently required to stand and/or sit. The employee is occasionally required to walk; sit and climb or balance. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, peripheral vision and depth perception. The noise level in the work environment is usually average. Conditions of Hire

• In accordance with CTHP policy, all employment at CTHP is "at will" and based on mutual consent. This means that the employee or CTHP may terminate employment at any time and for any reason with or without notice. No term of employment is expressed or implied for this "at-will" position.
• May be required to possess and maintain a valid driver license or capable of obtaining one; as well as be insurable by CTHP's company insurance.
• CTHP complies with the Drug-Free Workplace Act of 1988, whereby employees shall not manufacture, distribute, dispense, possess, use, or be under the influence of drugs or alcohol, and must pass a pre-employment and subsequent random drug and alcohol screening to be eligible for and maintain employment.
• CTHP has several positions which must comply with the

P.L. 101-630

Indian Child Protection and Family Violence Protection Act (ICPA); all employment offers in the "covered" classification are conditional until CTHP has received a Federal criminal background check verifying eligibility to work in these programs.

• Due to providing healthcare services, employees are subject to an annual TB screen and flu shot, should an employee opt to not take the flu shot they will be required to wear a face mask during flu season.

Covid 19 vaccine is required. See Covid 19 policy.

Job Type:

Full-time Pay:

$18.15 - $25.53 per hour Expected hours: 40.0 per week

Benefits:

401(k) Dental insurance Health insurance Life insurance Paid time off Parental leave Professional development assistance Retirement plan Vision insurance People with a criminal record are encouraged to apply

Work Location:

In person