Registration and Eligibility Expert

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: Conduct thorough interviews with patients or authorized representatives to gather information and determine eligibility for San Jose Clinic services.
  2. Document Management: Review, organize, and maintain accurate and up-to-date files and papers, ensuring that all necessary documentation is completed and verified.
  3. Financial Evaluation: Obtain, verify, and calculate income and resources to determine patient sliding-fee level eligibility.
  4. Program Eligibility: Ensure that program eligibility forms are completed as required and provide clients with a list 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, ensuring accurate and timely updates.
  7. Communication: Respond to client inquiries, refer patients to community service organizations as needed, and coordinate with patient access team members regarding eligibility status updates.
  8. Reporting and Record-Keeping: Complete monthly reporting and maintain eligibility status records in Excel, ensuring accurate and up-to-date records.
  9. File Maintenance: Maintain up-to-date and orderly eligibility files, adhering to San Jose Clinic policies and procedures.
  10. Community Outreach: Attend community outreach events as assigned, promoting San Jose Clinic services and building relationships with community partners.
  11. Cross-Training: Cross-train for all patient access responsibilities, ensuring a comprehensive understanding of clinic operations.
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, electronic medical records software, and Excel; 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.
Physical Requirements
  1. Physical Demands: Ability to sit, stand, bend, and stoop for long periods of time; ability to exert up to 50 pounds of force occasionally/frequently.
  2. Work Environment: Ability to work in a stressful environment; ability to respond to emergency/crisis situations; exposure to noise; exposure to blood and/or body fluids.


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