Enrollment and Retention Specialist

Interview clients on a one-to-one basis to determine eligibility for federal and state-funded health insurance programs; assess client eligibility and assist client to complete the application form; gather required eligibility documentation; submit applications to appropriate agency. Conduct outreach in the community to recruit clients eligible for federal and state-funded health insurance programs. Work with managed care entities to enhance patient enrollment and retention. Support LACHC’s mission to follow Christ by loving and serving our neighbors through comprehensive, quality healthcare and the vision the healing and restoration of homeless and underserved communities. Demonstrate Christ-like behavior and attitude in all job duties and responsibilities.

ESSENTIAL DUTIES AND RESPONSIBILITIES include:

• Enroll clients in California or federal health insurance programs as eligible:

o Screen clients by reviewing income information

(pay stubs, employer statements, etc…)

o Assist the client to complete the application (If necessary)

o Request and obtain the documentation necessary to complete

the application

o Submit the health program application to the appropriate agency

o Follow up with the agency to ensure the client received coverage

• Track and follow-up on submitted applications to ensure clients receive healthcare coverage.
• Conduct research on clients who have not received medical coverage (pending) or clients with denied claims because of insurance status with the goal of obtaining medical coverage for them and maximizing reimbursement.
• Conduct one-to-one and group outreach to explore for clients eligible to complete health insurance program applications.
• Keep current on rules and procedures of federal and state-funded programs including commercial carriers and other public services.
• Gain and maintain eligibility guidelines and documentation requirements for state and federal health insurance programs.
• Evaluate and resolve problems related to insurance issues and advocate for the client. Educate clients on how to access community resources.
• Handle all client information in a confidential manner.
• Perform clerical work as needed.
• Other duties may be assigned.

QUALIFICATIONS:

To perform this job successfully, an individual must be able to accomplish each essential duty satisfactorily. The following requirements are representative of the knowledge, skill, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

· Valid driver’s license required.

• Current personal vehicle insurance that complies with California minimum requirement.
• Must become a Certified Enrollment Counselor (Cover CA Certified) within 60-days of hire.
• Acceptable driving record.

· Must be fluent in English and Spanish.

· Detail-oriented.

· Demonstrated written communication...

· Ability to use word-processing and spreadsheet software to complete assigned tasks. Skilled in using office machines.

· Demonstrated organizational skills with the ability to prioritize and complete multiple tasks simultaneously; demonstrated skills in working independently or in a team setting; using independent judgment; and problem solving and troubleshooting.

• Demonstrated ability to work with clients of various socioeconomic backgrounds, disabilities, and cultures and with interpreters and clients for whom English is a second language.
• Demonstrated ability to communicate in a pleasant, non-judgmental, respectful, culturally sensitive manner under varying levels of stress (this may include high levels of noise, limited resources, etc.); demonstrated skills in handling difficult interpersonal interactions with discretion and diplomacy.

EDUCATION and/or EXPERIENCE:

High school diploma or GED. Minimum three years working in the areas of health promotion or community work required.

COMPUTER SKILLS: Computer proficiency required, including the ability to enter data with speed and accuracy

LANGUAGE SKILLS: Bilingual Spanish is required.

TRAVEL REQUIREMENTS & WORK HOURS: Limited to contractual/collaborative duties and professional education opportunities. Standard 40-hour week (4, 10-hr days or 5, 8-hr days) with occasional Saturdays or Sundays.

MATHEMATICAL SKILLS

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. Ability to apply concepts of basic algebra and geometry.

REASONING ABILITY

Ability to apply principles of logical or scientific thinking to a wide range of intellectual and practical problems. Ability to deal with nonverbal symbolism (formulas, scientific equations, graphs, musical notes, etc...) in its most difficult phases. Ability to deal with a variety of abstract and concrete variables.

CERTIFICATES, LICENSES, REGISTRATIONS

California Driver License; valid insurance. CPR Certification required.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee frequently is required to walk. The employee is occasionally required to stand, use hands to finger, handle, or feel, and reach with hands and arms. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include distance vision, color vision and peripheral vision. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. The noise level in the work environment is usually moderate but may occasionally be high at times. Working conditions are normal for an office environment. Work requires extensive work using a computer. While performing the duties of this job, the employee will be exposed to carriers of contagious diseases. The employee may have to deal with irate and irrational clients who may or may not be under the influence of mind-altering substances such as cocaine, marijuana, alcohol, etc.

WORK STATUS
Regular, Full-time, non-exempt position with Medical, Dental, Vision and 403B Retirement Plan with employer match. We are an equal opportunity employer. We will consider candidates with criminal histories.