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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 patient eligibility for various healthcare programs. This position involves processing applications for new patients and conducting thorough evaluations of existing patients to ensure accurate eligibility determinations across multiple payer sources.

About Tiburcio Vasquez Health Center: We are a dedicated non-profit community health center committed to enhancing the health and wellness of our community. Our services encompass primary care, dental care, WIC support, mental health counseling, and community health education, among others.

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

Compensation: The hourly wage is $23.95, commensurate with experience.

Key Responsibilities:

  • Conducts daily administrative tasks and general office duties, including word processing, filing, and data entry.
  • Welcomes new patients seeking medical services, assesses their eligibility for various programs, and explains payment options.
  • Ensures compliance with clinic policies regarding safety and confidentiality.
  • Maintains patient confidentiality and practices HIPAA compliance at all times.
  • Completes and verifies patient registration forms, ensuring accurate financial information is recorded.
  • Initiates new patient medical records and manages the logging of medical record numbers.
  • Creates and updates clinic cards for patients as necessary.
  • Informs patients about available services, billing policies, and their rights and responsibilities.
  • Advises patients on community resources for financial assistance and makes appropriate referrals.
  • Performs ongoing eligibility reviews for established patients as required.
  • Communicates with patients via mail or phone to gather necessary information for financial verification.
  • Ensures adherence to all regulations from funding sources at various governmental levels.
  • Treats all patients with respect and maintains a collaborative relationship with staff.
  • Collaborates with the Financial Eligibility Coordinator to ensure accurate data entry and reporting.
  • Utilizes problem-solving skills to address patient concerns and escalates issues as needed.
  • May require travel between sites and flexible working hours.
  • Adheres to the Service Excellence Standards of the organization.
  • Supports the implementation of Electronic Health Records and Practice Management systems.
  • Performs additional duties as assigned, 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 knowledge of state-funded programs is required.
  • A minimum of two years of clerical experience involving diverse responsibilities is necessary.

Skills:

  • Strong understanding of confidentiality and HIPAA regulations.
  • Excellent customer service and communication skills, with cultural sensitivity.
  • Ability to work effectively under pressure with minimal supervision.
  • Detail-oriented with strong organizational skills.
  • Proficient in computer usage, including email and internet applications.
  • Willingness to learn new data management systems.
  • Flexibility to work evenings and weekends as needed.

Benefits:

We offer a comprehensive benefits package that includes medical coverage (with 100% paid co-payments and premiums), dental and vision insurance, generous paid leave, Flexible Spending Accounts, retirement plans with employer matching, tuition reimbursement, and additional perks.