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Eligibility Review Specialist

2 months ago


Hayward, California, United States Tiburcio Vasquez Health Center Full time
Job Overview

The Financial Screening Clerk plays a crucial role in managing the eligibility assessments for patients enrolled in various programs. This position involves processing applications for new patients and conducting thorough evaluations for existing patients to ensure accurate eligibility determinations based on different payer sources.

About Tiburcio Vasquez Health Center: A dedicated non-profit community health center focused on enhancing the health and wellness of our community by providing accessible, high-quality healthcare services, including primary care, dental services, mental health support, and health education.

Position Details: This is a full-time role requiring 40 hours per week, typically scheduled from Monday to Friday, with occasional Saturday shifts.

Compensation: $23.95 per hour, commensurate with experience.

Key Responsibilities:

  • Conducts daily administrative tasks and general office duties, including word processing, filing, and data entry.
  • Welcomes new patients, determines their eligibility for services, and explains payment options such as MediCal and Medicare.
  • Maintains confidentiality and adheres to clinic policies regarding safety and security.
  • Ensures excellent customer service by treating all patients with respect and courtesy, while adhering to HIPAA standards.
  • Completes and verifies patient registration forms, ensuring accuracy in financial information.
  • Initiates medical records for new patients and maintains a log of assigned medical record numbers.
  • Informs patients about available services, billing policies, and their rights.
  • Advises patients on community resources for financial assistance and makes appropriate referrals.
  • Performs ongoing eligibility reviews for established patients as per clinic policies.
  • Communicates with patients via mail or phone to verify financial status or address details.
  • Ensures compliance with all regulations from various funding sources.
  • Collaborates with the Financial Eligibility Coordinator and Registration Services Coordinator for accurate billing and reporting.
  • Handles patient complaints with problem-solving skills and refers issues to designated personnel when necessary.
  • May require travel between different sites and flexible working hours.
  • Upholds the clinic's Service Excellence Standards in all duties performed.
  • Supports the successful implementation of electronic health records and practice management systems.
  • Performs additional duties as required, including potential rotation to various clinic locations.

Qualifications:

  • High school diploma or GED is mandatory.
  • Bilingual proficiency in English and Spanish is essential.
  • At least one year of experience in third-party billing and state-funded programs is required.
  • A minimum of two years of clerical experience involving diverse responsibilities is necessary.

Skills:

  • Strong understanding of confidentiality protocols, particularly under HIPAA.
  • Exceptional customer service and interpersonal skills, with cultural sensitivity.
  • Ability to work effectively under pressure with minimal supervision.
  • Attention to detail and proficiency in modern office procedures.
  • Basic math skills and computer literacy are required.
  • Willingness to learn new data systems and work flexible hours.

Benefits:

We provide a comprehensive benefits package, including medical coverage, dental and vision insurance, generous paid leave, retirement plans with employer matching, tuition reimbursement, and additional perks.