Access to Care Counselor

Position/Title: Access to Care Counselor

Reporting/Department Head: Access to Care Counselor Manager

• FLSA Status Non-Exempt
• EEO Category Administrative

Our Mission: To improve lives by providing comprehensive, high-quality healthcare to every person in every community that we serve.

Our Vision: CCHN will maintain its position as the leading community health center in the state and become a model for all other healthcare organizations to follow.

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Major Function: The Access to Care Counselor is responsible for assisting, collecting, reviewing, advising, determining eligibility, and referring CompleteCare Health Network patients/applicants in applying for medical and dental healthcare coverage in the State of New Jersey. To ensure patients/applicants obtain the best medical and dental coverage in the State of New Jersey they will meet with them to conduct an interview where they will be determined eligible for government or private medical/dental insurance.

Qualifications:

• High School Diploma or equivalent
• Knowledge of Family Care and uncompensated care regulations

Other Qualifications:

• Sitting for long periods of time

Experience:

• Experience working with the public, computer data entry, preferred knowledge of presumptive eligibility; family care, Medicaid and/or charity care and Reduced Fee programs. Bilingual preferred. Ability to work under pressure with high volume required. Excellent verbal and written communication skills required.

Job duties include, but not limited to:

The Access to Care Counselor at CompleteCare Health Network shall conduct an interview with the patient/applicant to determine eligibility and advise to apply for Medicaid, NJ Family Care, Long Term Sick program, Medicare, Marketplace, Reduced Fee, and Ryan White program including the CompleteCare internal programs such as Uninsured Slide and Insured Discount program.

• Reviewing key eligibility factors with each patient, such as income, marital status, age, residency, and citizenship from the family members
• Explain clearly to the patient the need to first refer them to other government programs
• Explain the necessary paperwork the patient will need to obtain if denied

Screen all inquiring patients/applicants for other government programs and referring applicable patients by:

• Ability to clearly explain to the patient/applicant that they may be considered eligible for other government medical/dental insurance before being place under any program at CCHN.

Accurately inform all applicable patients/applicants of required documentation needed to complete an application for the CCHN programs by:

• Discussing required documentation list with patient, and providing examples what qualifies for each document, if necessary.
• Knowledge of Emailing and Faxing documentations. Be aware that at times documents may need to me mailed.

Schedule all applicable patients/applicants for an Access to Care Counselor appointment at that time:

• Provide the patient with the next available and correct appointment time at the time you have completed the screening process and have determined they cannot be referred to another government program.
• Provide the patient with an emergency appointment when the need arises.
• Mail appointment/business card filling out the information with the appointment time

Perform confidential interviews for all applicable patients by:

• Follow the HIPPA Rules and regulations to protect patient information

• ACCs are responsible for their home office included but, not limited to two or three office departments; with this being said, ACCs will also responsible for attending all phone calls coming through their extension from the front office and patients, running Self-pay, PE reports and take care of all Uninsured walking patients coming to the office at any time, assist the front office financial questions, approved all applications for all CCHN programs if the patient is eligible for.

• Copying and attaching correct supporting documentation into the patients financial application.
• Obtaining patients signature with date on application for audit purposes.

• Signing and dating the application.
• Saving a pending application with all patient information with a clear explanation of documentation needed to complete application if unable to complete during the initial interview.
• Following for a second ACC appointment to complete pending medical/dental application after the initial visit.
• Also, ACCs, make income calculations, schedules provider appointments, file and organize applications and documents, review daily emails, reach out patients for assistance, handle and answer the phone, answer staff financial questions, run and present reports also attend meetings, etc.

The above job description is not to be construed as a complete listing of the assignments that may be given to any employee, nor are such assignments restricted to those precisely listed in the description.

EOE