Eligibility Specialist

7 days ago


Houston, Texas, United States San Jose Clinic Full time
Job Summary

We are seeking a highly organized and detail-oriented Eligibility Specialist to join our team at San Jose Clinic. As an Eligibility Specialist, you will play a critical role in ensuring that patients receive the necessary support and resources to access our services.

Key Responsibilities
  1. Eligibility Determination: Interview patients or authorized representatives to gather information and determine eligibility for San Jose Clinic services.
  2. Document Management: Review, organize, and maintain files and papers, ensuring accuracy and attention to detail.
  3. Financial Evaluation: Obtain, verify, and calculate income and resources to determine patient sliding-fee level eligibility.
  4. Program Eligibility: Ensure program eligibility forms are completed as required and provide clients with lists of required eligibility documents.
  5. Client Support: Provide information and educate patients on clinic procedures relative to contributions for San Jose Clinic services.
  6. Data Entry: Perform data entry of eligible clients into electronic systems.
  7. Client Communication: Obtain client information by answering telephone calls, interviewing clients, and verifying information.
  8. Scanning and Filing: Scan all necessary demographic, financial information, consents, and other missing documents required for registration and to properly determine San Jose Clinic eligibility.
  9. Application Monitoring: Monitor pending applications to ensure they are completed on a timely basis and follow up with patients daily to close out pending applications.
  10. Reporting and Record-Keeping: Complete monthly reporting and maintain eligibility status records in Excel.
  11. File Maintenance: Maintain up-to-date and orderly eligibility files.
  12. Community Outreach: Attend community outreach events as assigned.
  13. Cross-Training: Cross-train for all patient access responsibilities.
Requirements
  1. Education: High school diploma or equivalency; college degree preferred.
  2. Language: Bilingual English/Spanish required.
  3. Experience: Minimum one to three years of experience in a medical office, including at least one year of relative experience.
  4. Skills: Proficiently use computer medical management software, enter and update patient information as required, including daily input of patient and insurance information. Excellent communication skills, knowledge of standard office policies and procedures, knowledge of insurance eligibility requirements, skill in organizing time and managing multiple demands, ability to work independently and use good judgment in work prioritization, ability to complete difficult/complex tasks, and ability to follow oral and written instructions.
Physical Requirements
  1. Sitting and Standing: Ability to sit, stand, bend, and stoop for long periods of time.
  2. Physical Demands: Ability to exert up to 50 pounds of force occasionally/frequently.
  3. Work Environment: Ability to work in a stressful environment, respond to emergency/crisis situations, and be exposed to noise and blood and/or body fluids.


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