Eligibility Specialist
2 weeks ago
WHO WE ARE:
Are you interested in working for an organization whose mission it is to enable frail, underserved, and multicultural senior communities to live independently at home and in their communities, for as long as possible?
Orange County Program of All-Inclusive Care for the Elderly (PACE) is dedicated to providing its participants with comprehensive health and social supports that are proven to effectively manage chronic conditions and to reduce the risk for premature institutionalization. PACE staff are leaders in the "aging in place" industry and we have had the honor of serving Fresno, Bakersfield and Orange County seniors and their families/caregivers.
Job Summary:
Under the supervision of the Eligibility Supervisor, the Eligibility Specialist is responsible for resolving accounts receivable pertaining to participants' eligibility and enrollment issues. The Eligibility Specialist will ensure the goals and objectives of the Finance department are achieved while abiding to state and federal rules and regulations. This position is expected to be highly collaborative by working closely with other departments such as the Claims, Intake, and Social Work teams to remedy any eligibility/enrollment issues.
Essential Job Functions:
Duties include, but are not limited to:
Monitor participant eligibility/enrollment status as provided by state and federal agencies such as the Department of Health Care Services (DHCS) and the Center for Medicare and Medicaid Services (CMS)
Track eligibility/enrollment changes daily for documentation purposes
Track Medicare eligibility dates for all participants and work with Intake to ensure timely enrollment
Assist with retrospective and prospective enrollment/disenrollment efforts
Initiate and maintain proper follow-ups with DHCS and CMS to ensure timely processing and completion of all mandated applications and accompanying documentation Maintain knowledge of eligibility and enrollment requirements for individuals participating in the Program of All-inclusive Care for the Elderly (PACE), including but not limited to out-of-area issues, Share of Costs (SOC), Primary Aid Codes, and excluded benefits
Update enrollment/eligibility databases and other tracking spreadsheets including but not limited to Medi-Cal/Medicare eligibility issues •Assist all departments in confirming/verifying participant eligibility/enrollment status for internal and external inquiries for coordination of care
Attend and participate in staff meetings, in-services, projects, and committees as assigned
Adhere to and support the company practices, procedures, and policies including assigned break times and attendance
Accept assigned duties in a cooperative manner and perform all other related duties as assigned.
Be flexible in schedule of hours worked •Accept assigned duties in a cooperative manner and perform all other related duties as assigned
May require use of personal vehicle
Knowledge, Skills and Abilities:
Proficient knowledge of computer skills, including Microsoft Office (Word, PowerPoint, and Outlook)
Knowledge of general office procedures, equipment, and filing systems
Ability to communicate effectively, both orally and in writing
Ability to quickly learn department policies, procedures, goals, and services
Attention to detail and accuracy
Ability to change priorities regularly
Ability to think critically, take initiatives, and work independently with minimal supervision
Highly organized and ability to retrieve information quickly
Requirements
Experience
Minimum of two (2) years of professional experience in managed care organizations, required without an Associate's Degree
Experience in the health care field, preferred
Education and Certificatio n
Associate's Degree, required without professional experience
Is medically cleared for communicable diseases and has all immunizations up-to-date before engaging in direct participant contact
Salary Description
$20.00 - $22.00
#J-18808-Ljbffr
-
Eligibility Specialist
1 month ago
Anaheim, United States INNOVATIVE INTEGRATED HEALTH INC Full timeDescription: **WHO WE ARE**: Are you interested in working for an organization whose mission it is to enable frail, underserved, and multicultural senior communities to live independently at home and in their communities, for as long as possible? Orange County Program of All-Inclusive Care for the Elderly (PACE) is dedicated to providing its participants...
-
Housing Retention Specialist
2 days ago
Anaheim, United States Illumination Foundation Full time"Every person deserves compassion, dignity, and the safety of a place to call home." Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary services in our recuperative care...
-
Housing Retention Specialist
6 days ago
Anaheim, United States Illumination Foundation Full timeJob DescriptionJob Description“Every person deserves compassion, dignity, and the safety of a place to call home.”Homelessness is the largest social and public health crisis in California. Illumination Foundation (IF) is a growing non-profit organization dedicated towards disrupting the cycle of homelessness by providing targeted, interdisciplinary...
-
AR Specialist
4 weeks ago
Anaheim, United States Marquee Staffing - WFS Full timeJob DescriptionJob DescriptionAR Specialist Under minimal supervision the accounts receivable specialist will participate in the daily operations of the company’s accounts receivable collections cycle. The position requires the ability to operate in multiple capacities including collections, issue resolutions, and ensure completions of daily cash...
-
AR Specialist
1 day ago
Anaheim, United States Marquee Staffing - WFS Full timeJob DescriptionJob DescriptionAR Specialist Under minimal supervision the accounts receivable specialist will participate in the daily operations of the company’s accounts receivable collections cycle. The position requires the ability to operate in multiple capacities including collections, issue resolutions, and ensure completions of daily cash...
-
Insurance Verification Specialist
3 weeks ago
Anaheim, United States Anaheim HC, CA-ANA Full timePlanned Parenthood of Orange and San Bernardino Counties has a full-time opportunity for a Insurance Verification Specialist in Anaheim, CA.The Insurance Verification Specialist performs detailed insurance benefit verifications while effectively communicating with the patient, and front office staff, and corresponding with a variety of insurance companies....
-
Donor Relations Specialist
1 month ago
Anaheim, United States Planned Parenthood of Orange and San Bernardino Counties Full timeAdditional Comp Info: Salary based on experience. Overview: Planned Parenthood of Orange and San Bernardino Counties has a** full-time opportunity for a **Donor Relations Specialist - Event Focus** in Anaheim, CA.** The Donor Relations Specialist is responsible for supporting all fundraising and development activities within the Development Department,...
-
Litigation Specialist
6 days ago
Anaheim, United States City of Anaheim (CA) Full timeDescription The City Attorney's Office is seeking a highly motivated and organized Litigation Specialist to join our team. In this critical role, the Litigation Specialist will provide comprehensive legal and administrative support to the Civil Division of the department. Under minimal supervision, the Litigation Specialist is expected to perform...
-
Donor Relations Specialist
1 month ago
Anaheim, United States Planned Parenthood of Orange and San Bernardino Counties Full timeAdditional Comp Info: Salary based on experience. Overview: Planned Parenthood of Orange and San Bernardino Counties has a** full-time opportunity for a **Donor Relations Specialist** in Anaheim, CA.** The Event-Focused Donor Relations Specialist is responsible for supporting all fundraising and development activities within the Development Department,...
-
Principal Specialist, Procurement
1 month ago
Anaheim, United States Collins Aerospace Full time**Date Posted**: 2024-04-19 **Country**: United States of America **Location**: HCA11: Hoist & Winch 3355 E La Palma Ave, Anaheim, CA, 92806 USA **Position Role Type**: Onsite Collins Aerospace is looking for a Principal Specialist, Procurement for our Hoist & Winch team within Avionics. Do you have what it takes to be a buyer in the Aerospace Industry?...
-
Medical Billing Associate/Specialist
1 month ago
Anaheim, United States ALFEL RESOURCES INC Full timeJob DescriptionJob DescriptionBenefits/PerksCompetitive CompensationGreat Work EnvironmentCareer Advancement OpportunitiesJob SummaryAre you looking to launch a career in medical billing? Whether you're an experienced medical biller or a newcomer to the field, if you have a strong eagerness to learn, we want to hear from you!We are seeking a motivated...
-
Consumer Loan Sales Specialist
7 days ago
Anaheim, United States OneMain Financial Full timeAt OneMain , Consumer Loan Sales Specialists empower customers – listening to their needs and providing access to friendly, fast, and affordable financing for life’s expenses. Consumer Loan Sales Specialist will learn the lending and servicing business at OneMain allowing them to grow their career. I n the Role ...
-
Pest Control Specialist
2 weeks ago
Anaheim, United States Rentokil Initial Full time**Pest Control Specialist** CAROUSEL_PARAGRAPH * Anaheim, California * Technical Services * 30306 ** Share Job** ** Job Description** **Pest Control Specialist** **Benefits Start Day 1 for Full-Time Colleagues - No Waiting Period!** Western Exterminator Company is a member of the Rentokil family of companies, the global leader in Pest Control across more...
-
Pest Control Specialist
2 weeks ago
Anaheim, United States Rentokil Initial Group Full time**Pest Control Specialist** CAROUSEL_PARAGRAPH * Anaheim, California * Technical Services * 30746 ** Share Job** ** Job Description** **Pest Control Specialist** **Benefits Start Day 1 for Full-Time Colleagues - No Waiting Period!** Western Exterminator Company is a member of the Rentokil family of companies, the global leader in Pest Control across more...
-
Pest Control Specialist
2 weeks ago
Anaheim, United States Rentokil Initial Full time**Pest Control Specialist** CAROUSEL_PARAGRAPH * Anaheim, California * Technical Services * 30306 ** Share Job** ** Job Description** **Pest Control Specialist** **Benefits Start Day 1 for Full-Time Colleagues - No Waiting Period!** Western Exterminator Company is a member of the Rentokil family of companies, the global leader in Pest Control across more...
-
Pest Control Specialist
2 weeks ago
Anaheim, United States INITIAL, INC. Full time**Pest Control Specialist** CAROUSEL_PARAGRAPH * Anaheim, California * Technical Services * 30746 Rentokil ** Share Job** ** Job Description** **Pest Control Specialist** **Benefits Start Day 1 for Full-Time Colleagues - No Waiting Period!** Western Exterminator Company is a member of the Rentokil family of companies, the global leader in Pest Control...
-
Pest Control Specialist
2 weeks ago
Anaheim, United States Rentokil Initial Group Full time**Pest Control Specialist** CAROUSEL_PARAGRAPH * Anaheim, California * Technical Services * 30746 ** Share Job** ** Job Description** **Pest Control Specialist** **Benefits Start Day 1 for Full-Time Colleagues - No Waiting Period!** Western Exterminator Company is a member of the Rentokil family of companies, the global leader in Pest Control across more...
-
Quality Compliance Principal Specialist
1 month ago
Anaheim, United States Collins Aerospace Full time**Date Posted**: 2024-02-22 **Country**: United States of America **Location**: HCA11: Hoist & Winch 3355 E La Palma Ave, Anaheim, CA, 92806 USA **Position Role Type**: Onsite We are seeking a Quality Compliance Principal Specialist within our Quality organization to ensure AS9100 and Collins requirements are being met across the organization. This person...
-
Medical Billing Associate/Specialist
4 weeks ago
Anaheim, United States ALFEL RESOURCES INC Full timeJob DescriptionJob DescriptionBenefits:401(k) matchingCompetitive salaryHealth insurancePaid time offBenefits/PerksCompetitive CompensationGreat Work EnvironmentCareer Advancement OpportunitiesJob SummaryAre you looking to launch a career in medical billing? Whether you're an experienced medical biller or a newcomer to the field, if you have a strong...
-
Donor Relations Specialist
1 month ago
Anaheim, United States Anaheim Admin Full timePlanned Parenthood of Orange and San Bernardino Counties has a full-time opportunity for a Donor Relations Specialist in Anaheim, CA.The Event-Focused Donor Relations Specialist is responsible for supporting all fundraising and development activities within the Development Department, including event planning, database management, donor relations, gift...