Benefit Enrollment Specialist

Accountabilities

• Maintains regular, consistent, and predictable punctuality and attendance, including being available, accessible, and able to complete all required essential functions and assigned job tasks onsite as directed during your regularly assigned schedule or your assigned site(s) normal business hours.
• Demonstrates knowledge of all aspects of medical assistance programs available through the Department of Human Services.
• Evaluates patient’s circumstances and assists with accessing the benefit most advantageous to the patient’s family circumstances.
• Aids patients with the completion of the application process, including assistance in obtaining necessary documents, and submission of applications to the OHA Central unit or other program related processing center.
• Follows up on pending applications and update EPIC with insurance status.
• Works with billing department to identify potential covered charges that can be billed to DMAP or other insurance carrier.
• Enrolls patients via-phone or virtually.
• Determines eligibility for patient applying for CCARE and SCREENWISE and documents eligibility efforts in EPIC.
• Utilizes EXCEL and/or ACCESS program to track all patients potentially eligible for OHP, CHIP, and CAWEM.
• Provides monthly status reports to Management.
• Aids these groups with accessing medical benefits to support their ability to access ongoing medical care.
• Represents La Clinica at meetings and conferences, as directed.
• Maintains the confidentiality and privacy of patients, staff and the organization.
• Communicates effectively La Clinica’s mission and values to staff and clients.
• Participates in Migrant Camp Outreach Efforts.
• Follows workflows that result in capturing activities to meet patient engagement standards as outlined in the APCM program.
• Supports the development and implementation of standard workflow.
• Responsible for outreach efforts to ensure continuation of OHP eligibility and engagement in La Clinica services.
• Provides monthly status to direct supervisor.
• Facilitate team meetings.
• Conducts chart audit reviews.

Expected Abilities

• Must be able to multitask, work effectively with team members and at times work independently with minimal supervision.
• Will adhere to team agreements as well as assist with revisions as necessary.
• Will accept the responsibility for educating and adhering to the policies and procedures of La Clinica and its associated departments and programs.
• Assist in the ongoing improvement of the clinic.

Education And/or Experience Required

• Minimum: High School Diploma.
• Excellent interpersonal communication and problem-solving skills.
• Skills to intervene and promote reconciliation, compromise and positive outcomes in difficult interactions.
• Basic knowledge of Excel, SharePoint and Office Suite.
• Bilingual in Spanish and English.
• Skilled at using electronic health records as applicable to area of work (EPIC).

Preferred

• Basic knowledge of adult learning models.
• Six months of experience in related field or training.
• Skilled at using electronic health records as applicable to area of work (EPIC).

Equity Statement

At La Clinica, we commit to engage everyone in a welcoming, respectful, and loving way and to maintain the dignity and value of all people above everything else. These standards align with our organization’s vision of absolute excellence, open-hearted community, and well-being for all. For more information, please visit our website at: https://laclinicahealth.org/patients/approach/.