What are the responsibilities and job description for the Enrollment Specialist position at OLE Health?
DEPARTMENT: Membership Services
REPORTS TO: Enrollment Manager
SUPERVISION GIVEN: None
LOCATION: South Napa, CA
SCHEDULE: Mon to Fri, 8am to 5pm
PAY RANGE: $24.21 to $29.59
About CommuniCare OLE
Established in 2023, CommuniCare OLE is the result of a union of two health centers with a deep roots in their respective communities and reputations for providing high-quality primary care to all, regardless of insurance or ability to pay: OLE Health of Napa and Solano Counties and CommuniCare Health Centers of Yolo County. Building on a legacy established by both organizations in 1972, CommuniCare OLE is a network of federally-qualified health centers with 17 sites across Napa, Solano, and Yolo Counties. It offers comprehensive care, including medical, dental, behavioral health and substance use treatment, nutrition, optometry, pharmacy, care coordination, referrals, and enrollment assistance to more than 70,000 individuals, and no one is turned away due to lack of insurance, immigration status, or ability to pay. Many services are offered outside of its sites, including mobile health, home visiting, and community and school-based programs.
BENEFITS
- Medical, Dental, Vision Coverage
- Employer covers 90% of employee medical, dental and vision premium and 50% of dependent premium
- 18 days of PTO (Vacation & Sick)
- 10 Paid Holidays 1 Float Holiday
- 4% Employer Match for 403(b) retirement plan
- Tuition Reimbursement of up to $2,000 per Calendar Year for part-time and full-time employees (prorated per Full-Time Equivalent)
- Life & Accidental Insurance Coverage
- Employer contribution for Health Savings Account
- Flexible Spending Account (FSA) and Limited FSA Options
JOB SUMMARY: The Enrollment Specialist is responsible for welcoming new and existing patients and for facilitating patient access to qualify health care, health insurance coverage for which they may be eligible and to health and medical resources throughout CommuniCare OLE and the greater community.
KNOWLEDGE OF WORK
Knowledge of Federally Qualified Health Centers and the key health center principles and guidelines |
Knowledge of Medical Records System |
DUTIES AND RESPONSIBILITIES
Answers incoming phone calls that are directed to the Patient Services Department for: Appointments for application services |
Questions regarding CommuniCare OLE resources, site and patient program information New patient registration, including screening for appropriate health insurance coverage/program, and empanelment with a provider |
Utilizes medical records system to input patient registration information, provider match information and insurance information |
Conducts patient application assistance appointments for program screening to determine eligibility for Medicare, Medi-Cal, Cal Fresh, Covered California and other payment sources. |
Works with County eligibility representative to assist patient and their families with completing and submitting the appropriate health insurance application/s, including assistance with gathering necessary documents |
Tracks applications that are submitted and follow up with the appropriate agencies application and applicants as necessary. Contacts health plan and insurance company to verify patients’ insurance coverage and referral |
Provides support and education to assist families when a problem with health coverage arises |
Provides up to date, accurate information to patients regarding all programs and services available at CommuniCare OLE |
Processes monthly patient rosters for all CommuniCare OLE contracted managed care plans – PHP/Medi-Cal in reach |
Maintains patient renewal requirement data, contact families before their health plan renewal is due to prevent gaps in coverage and/or loss of insurance |
Assists patients with accessing financial and/or community resources when referred to outside medical providers or medical services (specialty care, hospital screenings, etc.) |
Assists patients and their families with referrals to in-house and community resources |
Attends meetings and trainings as needed to maintain up to date knowledge of services in CommuniCare OLE, State application assistance rules/guidelines, and community resources |
Performs other duties as assigned |
EDUCATION, EXPERIENCE, TRAINING
- High school diploma or general education degree (GED) required
- Bilingual Spanish and English required.
- Minimum 2 years directly related experience in healthcare
- Customer service skills in health care setting, clerical/administrative support (MS office, EMR, accurate filing)
- Strong organizational skills and expertise in broad range of insurance products and programs for the underserved is required.
- Excellent telephone and face-to-face communication skills (Spanish and English required). Demonstrated listening and problem-solving ability
- Ability to assess needs and ask appropriate questions to obtain needed information.
- Must be available to work weekends and evenings
- Must be able to provide own transportation to different sites
CommuniCare OLE requires pre-employment drug-testing (4-panel drug-test includes: amphetamines, cocaine, opiates, and PCP).
Salary : $2,000
