Eligibility Specialist
4 days ago
As an Eligibility Specialist at DataSF, you will play a crucial role in ensuring equitable access to quality healthcare for our community. The ideal candidate will possess strong analytical and communication skills, with the ability to work effectively in a fast-paced environment.
Job DescriptionThis position involves performing financial counseling, screening, and enrollment for medical coverage under various private and public healthcare programs, including Medi-Cal and Medicare. Key responsibilities include:
- Counsels patients on eligibility, billing policies, reimbursement programs, qualification standards, procedures, and payment options;
- Investigates payor requirements by obtaining benefits information, notifies insurance plans of patients' treatment needs;
- Assists patients in registering into the hospital, communicates accurate financial reimbursement information and eligibility verification to healthcare professionals;
- Maintains patient data, prepares, updates, and maintains records related to patient eligibility information and healthcare payment received;
- Regulates patient finances to maintain patient eligibility and entitlement to various benefits.
You will also be responsible for preparing patient budgets to determine eligibility for coverage of medical care, maintaining resource materials regarding regulations and procedures, and performing other related duties as required.
Requirements- Two (2) years of experience performing duties similar to an Eligibility Worker in a hospital, medical clinic, or community-based health organization;
- Must obtain Certified Enrollment Counselor Certification for Covered California within 3 months of hire;
- Bilingual fluency may be required depending on departmental needs.
Please note that applicants must clearly demonstrate how they meet the minimum qualifications.
How to ApplyThe City and County of San Francisco encourages women, minorities, and persons with disabilities to apply. Applications can be submitted through careers.sf.gov.
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