Eligibility Review Specialist

2 weeks ago

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

The Financial Screening Clerk plays a crucial role in evaluating the eligibility of patients for various healthcare programs. This position involves processing new patient applications and reassessing existing patients to ensure accurate eligibility determination 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 the community by offering comprehensive, high-quality healthcare services, including primary care, dental care, mental health support, and community health education.

Position Details: This is a full-time role requiring 40 hours of work per week, typically 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 such as word processing, filing, and data entry.
  • Interviews new patients seeking medical services, ensuring a respectful and dignified experience while determining eligibility for various payment methods.
  • Follows clinic policies regarding safety and security, maintaining confidentiality of sensitive information.
  • Delivers exceptional customer service, adhering to confidentiality protocols in line with HIPAA regulations.
  • Completes and verifies patient registration forms, ensuring accurate financial and personal information is recorded.
  • Initiates new patient medical records and maintains a log of medical record numbers.
  • Creates and updates clinic cards for patients as necessary.
  • Explains available services, billing policies, and patient rights to new patients.
  • Advises patients on community resources for financial assistance and makes appropriate referrals.
  • Conducts ongoing eligibility reviews for established patients as per health center policies.
  • Communicates with patients via mail or phone to gather necessary information for financial verification.
  • Ensures compliance with all relevant funding regulations at the state, city, county, and federal levels.
  • Treats all patients with courtesy and respect, upholding their rights to confidentiality.
  • Collaborates with the Financial Eligibility Coordinator and Registration Services Coordinator to ensure accurate billing and reporting.
  • Utilizes problem-solving skills to address patient concerns and escalates issues to designated personnel when necessary.
  • May require travel between sites and flexible working hours.
  • Adheres to TVHC's Service Excellence Standards in all duties performed.
  • Contributes to the successful implementation of electronic health records and practice management systems.
  • Performs additional duties as required, which may include rotation to different clinic locations.

Qualifications:

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

Skills and Attributes:

  • Strong understanding of confidentiality and HIPAA compliance.
  • Excellent interpersonal skills with a high degree of diplomacy and tact.
  • Ability to perform well under pressure and manage multiple tasks effectively.
  • Detail-oriented with a solid understanding of basic math and office procedures.
  • Proficient in computer usage, including email and internet applications.
  • Willingness to learn new data systems and adapt to changing environments.
  • Availability to work evenings and weekends as needed.

Benefits:

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

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