PACE Enrollment Specialist chez Family HealthCare Network

Description of Primary Responsibilities

1. Assists individuals and families in applying for and retaining health coverage by collecting required and accurate personal and demographic information, determining eligibility, assessing needs, providing accurate information regarding health coverage options, uploading/submitting verification documents, and completing applications.
2. Completes and submits health coverage applications. Initiates and maintains proper follow-up with patients and government agencies to ensure timely processing and completion of all mandated applications and accompanying documentation.
3. Monitors and initiates health coverage redetermination/renewal process for patients. Completes Medi-Cal Renewal Package, CCA Renewal Process, Reports all changes on active accounts, Medi-Cal Add-Ons. 
4. Facilitates referral to FHCN and community resources for assistance with other needs and intricate issues.
5. Maintains accurate and thorough records of all activities. Prepares statistical reports and patient/client correspondence. Submits monthly reports by the 1st of every month.
6. Promptly Provide responsive, high-quality service to patients and internal and external referral sources.
7. Provides follow-up activities as needed to ensure patients obtain and retain health coverage. A significant focus will be on assisting high-acuity patients requiring more intensive assistance (i.e., seniors) to provide no lapse in coverage.
8. Supports the Intake Coordinator in outreach and education activities for internal and external referrals.
9. Supports Intake Coordinator with on-site training for staff as needed, utilizing appropriate procedures and training templates.
10. Manages the enrollment phone line, including telephone screening and providing education on the PACE plan. 
11. Responsible for performing various aspects of patient visits during check-in.
    • Collects accurate demographics and insurance eligibility information.
    • Registers new and established patients according to expected workflows.
    • Captures and updates insurance information in the patient’s record.
    • Completes enrollment and necessary forms for financial programs.
    • Ensures forms and insurance cards/eligibility are scanned and indexed appropriately and timely.
12. Responsible for obtaining medical record releases and processing medical record requests.
    • Performs documentation in the patient’s electronic health record according to policy and training.
13. Performs other duties as assigned. 

Description of Primary Attributes

Professional & Technical Knowledge:

1. High School Diploma or GED equivalent required.
2. Preferred:  Bachelor’s degree in a health or human service field.
3. A minimum of one year of experience performing eligibility insurance or billing experience.
4. Related education may substitute for experience. 

Technical Skills:

1. Ability to prepare more complex documents in Microsoft Word, including creating tables, charts, graphs, and other elements.
2. Ability to use Microsoft Excel to review and compile data, including formulas, functions, lookup tables, and other standard spreadsheet elements.
3. Ability to create introductory presentations in Microsoft PowerPoint.

Licenses & Certifications:

1. A valid California driver’s license.

Communications Skills:

1. Job duties require compiling information prepared in effective written form, including correspondence, reports, articles, or other documentation.
2. Effectively conveys technical information to non-technical audiences. 
3. Communicate verbally and in writing effectively with individuals from varying cultures and backgrounds. Prepare concise and clear reports.

Physical Demands: The physical demands described here in this job description represent those that an employee must meet to perform the essential functions of this position successfully. Reasonable accommodation may be made to enable individuals with disabilities to perform essential functions.

Work Environment: While performing this position's duties, the employee must regularly sit and use repetitive hand movements to type and grasp. The employee is frequently required to stand or walk and occasionally bend or twist the waist, squat, climb, kneel, reach above and below shoulder height, and move items up to 20 pounds. 

Pay Scale:

Min Hourly Rate: $21.56

Max Hourly Rate: $29.75