Financial Eligibility Worker

About the Role

The Financial Eligibility Worker will assist NECC patients who do not have medical insurance coverage by guiding them through the application process and enrolling them in various insurance programs if qualified.

Responsibilities

• Review provider schedules and identify patients with no medical insurance coverage, including:
  • Newborns
  • Children previously seen under Gateway and/or Public Private Partnership (PPP) Program
  • Patients with Share of Cost
• Screen families and educate them on available health insurance programs and necessary qualifications.
• Enroll patients according to their qualifications.
• Assist patients with all necessary forms for initial enrollment and redetermination processes.
• Assist patients with other forms and paperwork pertaining to health insurance coverage.
• Conduct follow-up with applicants to ensure required documentation is submitted and inform patients of approved coverage.
• Act as a patient advocate and liaison between patients and the clinic to ensure 100% patient satisfaction.
• Identify and resolve issues that could lead to member dissatisfaction or affect retention.
• Help patients with insurance-related questions.
• Other duties as assigned by the HCC Coder, Clinic Manager, or Operations Director.

Requirements

• High school diploma or GED equivalent.
• 1 year minimum experience in similar job-related duties.
• Proficiency in Microsoft Office (Word, Excel, Outlook).
• Excellent communication and customer service skills.
• Bilingual (English/Spanish) preferred.
• Ability to work as a team player and independently.
• Reliable transportation; must be able to travel from facility to facility.
• 10% travel outside the local area required.
• Commitment to the goals and philosophy of Northeast Community Clinic.
• Valid state identification.

Schedule

Flexible; may require some evenings and weekends.

Physical Requirements and Working Conditions

• OSHA Category 2 – Typically involves no regular exposure to blood, body fluids, or tissues but may require unplanned tasks involving exposure.
• Majority of work is sedentary but requires regular communication, repetitive motions, and occasional movement.
• Regularly required to push, pull, and lift up to 20 pounds; occasionally up to 40 pounds.
• Must possess mobility to work in standard office and clinic settings, use standard equipment, and maintain attention to detail despite interruptions.
• Ability to read printed materials, use a computer, and communicate in person and over the telephone.