ELIGIBILITY & ENROLLMENT COUNSELOR

Description

ORGANIZATION

The mission of Ravenswood Family Health Network (RFHN) is to improve the health of the community by providing culturally sensitive, integrated primary and preventative health care to all, regardless of ability to pay or immigration status, and collaborating with community partners to address the social determinants of health.

POSITION SUMMARY

The Eligibility & Enrollment Counselor (also referred to as Community Health Advocate: CHA) works under the direct supervision of the CHA Supervisor to screen and provide enrollment assistance to uninsured adults and children in San Mateo and Santa Clara Counties. The CHA is a Certified Enrollment Counselor (CEC) by the State of California and participates with various community enrollment sites and attends community health events. They are responsible for eligibility screening, conducting enrollments, responding to inquiries, and registering or re-registering new and established Ravenswood Family Health Network (RFHN) patients.

DUTIES AND RESPONSIBILITIES

To be performed in accordance with RFHN Policies and Procedures

1. Becomes a Certified Enrollment Counselor (CEC) through the State of California and completes Community Health Advocate training through County partners.
2. Assists applicants in gathering the verification documents needed to apply for various Federal, State, and County Community Program processing systems.
3. Enters application information in the appropriate software systems.
4. Facilitates the screening and referrals of all Gateway well child visits to determine if these uninsured children are eligible for coverage.
5. Collaborates with health coverage partners of San Mateo and Santa Clara Counties, and community-based organization (CBO) partners on improving the delivery of the various program services.
6. Participates in San Mateo and Santa Clara County partners’ coalition and regional health outreach meetings to discuss issues regarding outreach barriers and best practices, retention strategies, eligibility processing issues, etc.
7. Conducts community and interagency presentations on various healthcare insurance programs and County coverage programs (listed in #8 below).
8. Participates in community health events to inform and screen uninsured families eligible for Medi-Cal, Kaiser Health Plans, ACE, PCAP, Covered California, and RFHN’s Sliding Fee Scale (self-pay).
9. Responds to internal questions and requests from staff about the eligibility and enrollment process.
10. Reviews applications on a monthly basis to confirm whether cases are pending, approved, or denied.
11. Informs, educates, and reviews coverage payments and details of coverage with applicant.
12. Provides healthcare insurance plan billing and payment information to applicants.
13. Conducts telephone enrollments and/or home visits when needed.
14. Links information from enrollment platforms to RFHN’s Epic system.
15. Registers new and re-registers established patients by entering demographic information into the computer, printing out a registration form, having the patient sign the Consent for Treatment Statement, and filing the registration form in the medical record.
16. Collects Power of Attorney, Guardianship, Emancipation, Asylum, or any other legal form pertaining to identity or patient care.
17. Maintains all patient information confidential at all times.
18. Assists patients in navigating to other internal and external services as needed.
19. Provides consistent and accurate case management with minimal supervision on an ongoing basis, including but not limited to charting, referrals, follow-ups, and other important eligibility and enrollment information.
20. Greets patients and visitors in a prompt, courteous, and helpful manner.
21. Answers telephones, provides information, screen calls, takes messages, and/or directs calls to the appropriate individual.
22. Screens visitors and responds to routine requests for information.
23. Maintains work area in a neat and orderly manner.
24. Assists as a float covering CHA at Ravenswood and MayView campuses, and covering the CHA Front Desk at Ravenswood when needed.
25. Other duties as assigned and requested.

Qualifications

QUALIFICATIONS

• High School diploma or GED and minimum one year of work or volunteer experience in a job/internship performing customer service required.
• Bilingual Spanish/English proficiency required.
• Current Basic Life Support certification required.
• Current California drivers’ license and ability to travel between clinics.
• Experience in a healthcare setting as a Certified Enrollment Counselor strongly preferred.
• Knowledge of business office procedures, proficiency with Microsoft Office and electronic health records, Epic preferred.
• Reliable, organized, detail-oriented with a high degree of accuracy.
• Ability to understand and carry out oral and written instructions; to maintain complex records and files; to meet and deal effectively with the public.
• Ability to work under pressure and efficiently manage multiple tasks and priorities.
• Excellent customer service skills and professional demeanor.
• Ability to communicate tactfully and effectively both orally and in writing.
• Experience working effectively with a multi-cultural and economically diverse population.
• Ability to work with all types of clients regardless of their race, immigration, housing or financial status.
• This is a highly confidential position requiring mature judgement and compliance with HIPAA, audit requirements, and other regulations.
• Commitment to support and implement the philosophy, goals, and objectives of RFHN.
• Up to date with COVID-19 vaccines per current CDC guidelines strongly recommended.

The pay range for this position is $23.00 to $32.00 per hour.  However, the final base pay will be determined upon a number of individualized factors such as (but not limited to) the scope and responsibilities of the position, job-related knowledge, skills, experience, education and certification levels, and departmental budget. We also consider internal equity with our current employees when making final offers.

Ravenswood Family Health Network is an equal opportunity employer.

Salary : $23 - $32