Eligibility Specialist
3 weeks ago
**Overview**:
Works in Federally Qualified Health Center. Provides admissions and eligibility services to Avenue 360 Health and Wellness clientele to maximize all available resources to each client and/or family member. The eligibility worker is one of three members of the practice management team and may be expected to substitute and perform patient facing duties as assigned. This position reports to the practice manager and adheres to all agency policies and procedures.
**Duties and Responsibilities**:
- Performs admissions and eligibility processes (intake, reassessments, etc.) to ensure appropriate placement of clients within Avenue 360 Health and Wellness internal continuum of care including but not limited to medical, dental, and behavioral health.
- Screens and assesses individual and family client needs, which form the basis for the client’s service or treatment plan.
- Performs insurance coverage and grant eligibility verifications by making field calls or using other verification tools.
- Updates client demographic information and financial information/documentation at each visit or when the client’s situation changes to ensure on-going service eligibility and compliance with all local, state, and federal regulations.
- Able to perform front desk functions including but not exclusive to scheduling, greeting (arrival and check-in and answering phone calls), and time of service collections.
- Documents all services in the electronic health record and practice management systems.
- Participates in quality management and quality assurance activities.
- Other tasks as assigned.
**Education, Experience, Licensure/Certification** **and **Skills/Abilities **Related Requirements**:
A High School Diploma or Equivalent.
Excellent written and verbal communications skills.
Excellent interpersonal skills and adherence to agency mission and values.
Excellent customer service skills with a compassion and kindness for community at large.
Knowledge of social service community resources (e.g., food supplement, primary care safety-net, HIV/AIDS, Homeless, and Mental Health/Substance Abuse).
Language: Bilingual (English and Spanish) preferred.
**Continuing Education **and Training Requirements:
Participates in trainings required by the funding source.
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