Eligibility Coordinator

About the role

This is a great opportunity for an individual passionate about serving the underserved community in Los Angeles County. This person will help bring the PACE (Program of All-Inclusive Care for the Elderly) to many underserved frail seniors in the community. This individual will assist in helping frail seniors apply for Medicaid or Medicare.

Responsibilities

• Initiates, assists, and manages Medi-Cal application for prospective participants, ensuring timely and accurate completion of the process.
• Conducts home visits to complete the Medi-Cal application process.
• Affords assistance to participants, families/caregivers in completing all necessary paperwork needed for Medicaid re-determination or new applications.
• Maintains all documentations and records all enrollments in CRM software and ensures accuracy and compliance.
• Strictly adheres to DHCS and CMS regulations and policies regarding marketing practices for the PACE Program.
• Collaborates with the Finance Department to prepare various reports for data analysis purposes.
• Supports the Finance department to validate Medicaid payments.
• Maintains participant’s Medicaid eligibility (recertification of Medi-Cal).
• Supports the Enrollment and Outreach Specialist as needed.
• Provides community resources to prospective participants or families/caregivers.
• Collaborates with or contacts county/state government specialists to ensure the submission of required documentation or to obtain additional information.

Qualifications & Experience

• Knowledge of California Medi-Cal System and Social Security process.
• Two to four years of relevant experience.
• Experience working with state/county eligibility workers.
• Experience working with frail elderly.
• Tuberculosis Screening Policy: Bilingual (Spanish, Cantonese, Mandarin, Vietnamese preferred).