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Community Enrollment Specialist
2 months ago
MLK Community Healthcare is seeking a highly motivated and detail-oriented Community Enrollment Specialist to join our team. As a key member of our outreach and enrollment team, you will play a critical role in helping patients and clients navigate the healthcare system and access the resources they need.
Job Summary:The Community Enrollment Specialist will assist patients and clients in enrolling into Medi-Cal, Covered California, and other health insurance programs. You will work closely with our patients and clients to understand their needs and provide personalized support to ensure they receive the best possible care.
Key Responsibilities:- Screen patients and clients for eligibility and provide assistance with enrollment into Medi-Cal, Covered California, and other health insurance programs.
- Develop and implement a systematic referral network plan to assist with MLKCH growth.
- Assist patients and clients with establishing care at MLKCH as their primary care home and booking appointments.
- Monitor, analyze, and report activity against established monthly goals.
- Run eligibility status for patients and clients through Next Bar Experian and ensure enrollment is assigned correctly under appropriate PCP/Clinic/Medical Group.
- Maintain and update all patient/client records in regards to benefits via Revenue Cycle and/or EHR system.
- Review status and follow up to confirm enrollment, encourage the utilization of health insurance benefits and services.
- Provide education and health enrollment assistance to potential patients in the community about healthcare options, including Medi-Cal, Covered California, Healthy Families, Cal-Fresh, and others.
- Assist those experiencing difficulties with enrollment, utilization, and retention, and offer retention assistance.
- Identify outreach locations in the community to provide health coverage and other government-sponsored programs.
- Drive enrollment results through the implementation of the outreach and enrollment plan for the designated area.
- Make sure that prenatal patients and their newborns are enrolled in Medi-Cal, Covered California, and/or other healthcare options available.
- Work with the Supervisor of Social and Community Relations to develop target outcomes for enrollment, outreach initiative, and maintain an extensive awareness of community-based patient resources.
- Adhere to all policies as set forth by Medi-Cal and Covered California and government-sponsored programs.
- Prepare monthly community enrollment and outreach report, documenting contacts generated, follow-up activities, and estimates of resources needed for next strategic steps.
- Attend/conduct any community health fairs and other places where people congregate for enrollment assistance and MLKCH growth.
- Assist MLKCH growth and reputation initiatives efforts targeting potential patients and eligible community members, including participating in presentations and open enrollment activities.
- High school diploma or GED required. Associate's Degree, Bachelor's Degree, in Healthcare, Business Administration, or related field preferred.
- Certified Application Assister (CAA) certification required.
- Certified Enrollment Counselor (CEC) certification preferred.
- Bilingual English/Spanish required.
- Two (2) or more years of experience working with Medi-Cal, Covered California, health insurance programs, and other public benefits.
- Experience working with individuals from diverse ethnic, educational, cultural, and socioeconomic backgrounds, gender identity, and sexual orientation.
- Interest in advocating and promoting healthcare accessibility.
- Exceptional interpersonal skills and team player.
- Follow agency policies and maintain organizational standards with regards to patient/client confidentiality and HIPAA compliance.
- Current valid California Driver License and Insurance Certificate.
- Proficiency in Windows computer software, web-based portal systems, and internet web browsers.
- Strong verbal and written communication skills and active listening skills.
