* Review the hospital census or utilize established referral method to identify self-pay patients on a daily basis.
* Interviews and screens patients to determine eligibility for Medi-Cal, Covered California, Workers Compensation, CCS and any other federal, state or local government program.
* Assists patients and community members with completing and submitting applications through Covered California and other benefit applications and follow through until approved.
* Responsible for tracking and reporting all required data for enrollment and outreach efforts.
* Schedules, conducts and tracks patient assistance, follow-up and outcomes.
* Advocates for patients with County and State Social Service agencies by helping file appeals and other actions.
* Attends all eligibility related meetings and trainings.
* Utilizes Cerner and other electronic systems to enter patient information and research history.
* Conducts outreach with other county organizations to screen uninsured patients for health insurance and/or other programs.
* Verifies current insurance information to send the patient to the appropriate facility.
* Contacts Medi-Cal to obtain authorizations to ensure reimbursement of services.
* Follows up on all referrals and maintains accurate tracking in Cerner.
* Successfully manage multiple tasks and priorities without missing deadlines.
* Request home visits as needed to acquire documentation
* Assist the applicant with gathering any additional reports or records, meeting appointment dates and times.
* Ability to effectively communicate with patient financial services, patient access and county eligibility worker.
Speak and read English at a level that is sufficient to satisfactorily perform the essential functions of the position. Knowledge of standard office equipment (i.e., calculator, fax, photocopier) and personal computer and computer software skills (i.e., MS Windows, Excel, Access, Word, Powerpoint, internet, e-mail). Windows computer skills including proficient use of keyboarding, use of mouse or keys for functions such as selecting items, use of drop down menus, scroll bars, opening folders, copying and similar operations required upon employment or within the 1st two weeks of employment to perform the essential functions of the job. Performs other duties as assigned. Follows Palomar Health rules, policies, procedures, applicable laws and standards. Carries out the mission, vision, and quality commitment of Palomar Health.
|High School Diploma and/or combination of education and experience
|High School Diploma and/or combination of education and experience plus 1 year healthcare-related experience or basic college/medical coursework to learn medical terminology
|2 years' experience assisting patients with insurance and government funded programs in a medical or human services setting
Bilingual - Spanish
|3+ years' experience assisting patients with insurance and government funded programs, including knowledge of Medi-Cal and Medicare-related benefits and other programs for low-income
|Certified Enrollment Counselor within 30 days of hire
We are an equal opportunity employer and do not discriminate against applicants or employees based on race, color, gender, religion, creed, national origin, ancestry, age, disability, sexual orientation, marital status or any other characteristic protected by law.
© 2024 Palomar HealthPowered by Jobvite