The Patient Eligibility and Enrollment Specialist reaches out to uninsured persons receiving care at CHC and those living in the local service area and establishes linkages to CHC clinics and health insurance. This position will work to provide outreach opportunities for community residents who lack access to healthcare and health insurance and provide patient related services regarding enrollment and eligibility for various payers; assists patients in completing applications on-line and qualifying for sliding fee discounts. Coordinates with outside caseworkers to enable qualified clients to enroll in Medicaid services or other appropriate public health programs and services. Minimum QualificationsKnowledge, Skills & Abilities
Job Specific Functions/Performance Expectations:1. Be the subject matter expert for staff on all aspects of the insurance programs and the sliding fee discount program.2. Verify insurance coverage for future scheduled appointments using practice management system appointment reports.3. Provide enrollment assistance for uninsured patients to access subsidized, low-cost and free health insurance programs through the health insurance marketplace (Washington Healthplan Finder) and Washington Apple Health; as a role of a navigator.4. Assist patients in completing and processing applications and qualifying for sliding fee discount program.5. Assist patients in completing coverage applications, gathering required documentation and solving issues that may arise during the enrollment process.6. Follow up on outstanding sliding fee applications and enters tracking data into sliding fee database.7. Provide structured patient education on health coverage, engage in follow up conversations and offer renewal assistance for enrolled individuals.8. Coordinate with Community Health Workers to enable qualified clients to enroll in Medicaid services or other appropriate public health programs and services.9. Maintain Breast and Cervical Health Database, works with Provider to ensure all necessary paperwork is completed and verifies patient eligibility.10. Research patient questions regarding accounts/statements and initiates appropriate adjustments with the assistance from the Billing Department11. Assist and educate patients as new insurance options come available, identifying the affordable coverage that best meets their needs.12. Assists in the distribution of outreach materials to patients, community members, partner organizations and businesses to build insurance coverage option awareness.13. Attend and successfully complete all required training programs; participate in ongoing conference calls, webinars and other professional development opportunities.14. Adhere to attendance standards in order to perform the job functions for daily operations and/or continuity of patient care.
Posted on : Sat, 20 Apr 2019 17:09:16 GMT
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