Eligibility Coordinator

Except in the case of an undue hardship, La Familia provides reasonable accommodations to persons with disabilities when the accommodations are necessary to enable the persons to perform the essential functions of the job. The Agency also provides reasonable accommodations when necessary based on religious needs. Individuals requiring workplace accommodations must discuss their needs with La Familia Human Resources. Individuals seeking accommodations for disabilities are typically required to provide medical documentation supporting the existence of a disability, the need for the accommodation, and what workplace modifications will enable the employee to perform the essential functions of the job.

POSITION OVERVIEW:

As part of La Familia’s Community Health Center front office team, prepares and submits required eligibility screening and information for all patient visits at the health center. Responsible for providing enrollment, assistance, information and support to new and established patients in determining eligibility for health services under various private and public health care assistance programs. Also serve as patient registrar and navigator for new patients to their health center. Provide screening and enrollment at community outreach events. This position reports to the Clinic Director/Administrator and works closely with Finance Dept., external CRM vendors and health center staff. This role will uphold and champion the agency’s mission, vision, and values and contribute to a collaborative and inclusive work culture. 

ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES: 

Administrative Duties: 

• Responsible for preparing all eligibility information for each scheduled clinic patient at least two days ahead of the appointed time. 
• Works collaboratively with front desk staff to ensure that all scheduled and non-scheduled patients are checked for eligibility and that all information is entered accurately and thoroughly.
• Interviews and screens new and established patients to determine eligibility for health insurances and other programs. 
• Serves as an initial point of contact for patients looking to enroll in primary care services. 
• Enters and documents pertinent patient messages, eligibility information, and alerts in the patient's chart or electronic health records as needed to ensure accurate communication and coordination between the front office and billing department regarding patient eligibility status. 
• Assists patients and community members with completing and submitting applications for county and state benefit programs. 
• Registers new patients, schedules appointments and provides information on La Familia Community Health Center locations, services and available programs. 
• As part of the health center front office team, assists with front office operations at the health center as needed. 
• Responsible for tracking and reporting all required data for enrollment and outreach efforts to support program goals, compliance requirements, and performance monitoring.  
• Conducts timely follow-up with prospective patients through phone, email, and in-person contact to guide and support their enrollment process from initial inquiry to intake completion. 
• Maintains accurate statistical records, reports, and tracking systems to monitor enrollment activities, outreach efforts, and program outcomes. 
• Attends all meetings that apply to the eligibility process and shares the information with appropriate clinic personnel. These meetings are typically off-site and will require the use of personal vehicle or other transit.  
• Takes all classes and tests to become a Certified Enrollment Counselor.

Compliance Duties

• Adhere to federal and state regulations governing eligibility determination.
• Attend eligibility-related meetings; assist with referrals to Medi-Cal and CalFresh.  
• Maintain detailed records for County, State and HRSA and funding compliance.
• Participate in eligibility department audits and trainings.
• Strong attention to detail and organizational skills for accurate eligibility verification and documentation.
• Ability to maintain confidentiality (HIPAA) and handle sensitive financial/insurance information.

Other 

• Participate in community outreach events to promote enrollment services.
• Provide interpretation and navigation support for LEP patients.
• Attend trainings and participate in events relevant to key responsibilities.
• Track and regularly report on key metrics for the responsible function areas.
• Leads and collaborates on projects supporting Agency objectives. 
• Performs other duties and projects as assigned. 

CORE COMPETENCIES:

Leading the self:

• Demonstrates ethics and integrity 
• Displays drive and purpose
• Manages self and adapts to change
• Exhibiting leadership stature
• Practice self-awareness and continuous learning 

INCLUSION, RESPECT, AND COLLABORATION:

• Exhibit inspirational leadership by being highly responsive, leading a team to resolve immediate issues while strategically and inclusively addressing root causes. 
• Develop staff by providing support to allow them to flourish in their roles, and promote a culture where everyone is valued and included, fostering a sense of belonging in an environment where employees can reach their full potential. 
• Practices cultural humility and cultural responsiveness when engaging with individuals from diverse backgrounds and life experiences, while practicing appropriate boundaries. 

QUALIFICATIONS & EXPERIENCE:

• High school diploma or GED required. Associate Degree preferred. 
• Minimum 3 years of experience in patient registration, insurance verification, eligibility determination, or enrollment experience strongly preferred
• Two years’ experience in a community health care environment, FQHC, public health or primary health care setting preferred. 
• 2-3 years of experience in Medi-Cal eligibility, Covered California enrollment, and other public/private insurance programs strongly preferred.
• Bilingual (English/Spanish or other language relevant to community) strongly preferred.
• Experience working in an FQHC, community clinic, or safety-net environment is highly desirable.
• Strong understanding of healthcare eligibility requirements, including Medi-Cal, Medicare, commercial plans, and sliding fee scales.
• Knowledge of HRSA health center program requirements for patient eligibility and sliding fee discount programs.
• Proficiency in Electronic Health Records (EHR) and eligibility verification systems.
• Excellent customer service and communication skills, especially with underserved and diverse populations.
• Demonstrates and models excellent “customer service” orientation and ability to work with diverse populations. 
• Exercises extreme discretion with the ability to hold, balance, and transmit public and confidential information needed by various parties. 
• Proficient in MS Office and Google Workspace products.
• Valid CA Driver’s license required. 
  • Auto insurance: If your vehicle is used for business-related purposes, it is recommended that you inform your auto insurance carrier. 

OTHER RESPONSIBILITIES:

• Demonstrates cultural awareness and provides respectful, client-centered care. 
• Maintains knowledge of community resources for client referrals 
• Attend work regularly, adhering to policies on absences and tardiness. 
• Understands and applies legal requirements, including confidentiality and risk management.

Timekeeping & Attendance Responsibilities

• Accurately record work hours each day by clocking in/out at scheduled start, break, lunch, and end times.
• Take all required meal and rest breaks in compliance with state, federal, and agency policies.
• Review and submit timesheets by established deadlines to ensure timely payroll processing.
• Notify supervisor promptly of any scheduling conflicts, absences, tardiness, or timekeeping issues. 
• Maintain consistent and reliable attendance to support team and program operations.
• Follow organizational policies and procedures related to overtime, schedule changes, and paid/unpaid leave.
• Correct and/or report any timekeeping discrepancies immediately to the supervisor for resolution.

TEAM COMMITMENT:

• Viewed by others as an effective team member who is flexible, cooperative, and willing to assist others, and acts as a resource to team members and clients, where appropriate.
• Handles difficult or conflict situations constructively and seeks appropriate assistance.
• Accepts accountability and constructive feedback.
• Attends all mandatory meetings and staff meetings as required, and actively participates in other departmental professional development, including providing training and consultation.
• Develops and maintains cooperative and courteous relationships with fellow employees, supervisors, managers in other departments, senior management, executive staff, and community stakeholders.
• Handles requests, suggestions, and complaints from other departments and individuals in a tactful and effective manner to maintain goodwill within the agency.  

WORKING CONDITIONS and JOB SETTING:

• Ability to occasionally or frequently stand, walk, sit, and reach with hands and arms above the shoulders 
• While performing the duties of this job, the employee is routinely required to sit, walk, talk, and hear, use hands to keyboard, fingers, handle, and feel, stoop, kneel, crouch, twist, crawl, reach, and stretch.
• The employee is occasionally required to move around the office
• Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and the ability to adjust focus 
• May require travel, dependent on agency needs
• Can work under deadlines
• Performing general physical activities such as picking up, moving, and using objects, tools, or controls
• The noise level in the work environment is usually low to moderate.

Physical Requirements

• Ability to safely operate a motor vehicle
• Ability to push, pull, and lift up to 50 pounds frequently.
• Ability to stand and move from one location to another daily. 
• Ability to sit for prolonged periods of time
• Ability to visually focus on near and far items, and to be able to switch between them.
• Ability to reliably report to work on time and perform the position's required tasks as scheduled
• Ability to grasp and carry items
• Ability to hear and effectively communicate with co-workers, clients, and the public
• Ability to identify potential issues within the workplace, determine an appropriate means of avoiding and/or resolving the issues, work with others to address the issues, and carry out organized strategies for resolving and preventing similar issues in the future
• Ability to process information and data for use within the organization

BENEFITS:

• Excellent Health benefits package for you and your family, including: 
  • Medical, dental, and vision benefits with 95% employee and 80% dependent employer premium contributions, and employer-paid life insurance.
• Vacation, 15 paid holidays, 12 paid sick days upon accrual
• Employee Assistance Plan to support you and your family’s well-being and finances 
• Pet Plan Benefit: 
  • PetPlus Product and Prescription Discounts, Pet Assure Veterinary Discounts, AskVet 24/7 Pet Telehealth, and ThePetTag Lost Pet Recovery Service
• 403(b) retirement plan
• Work-life wellbeing & excellent work hours
  • La Familia understands the importance of work-life balance! Our therapists enjoy flexible scheduling options, including hybrid work arrangements, to ensure high-quality client care while maintaining their well-being.
• License and Certification renewals reimbursed.
• Supportive/Collaborative work environment 
• Opportunities for Growth and Professional Development
  • We believe in growing together. As a team member, you’ll have access to structured mentorship and ongoing training. Whether you’re pursuing licensure or looking to specialize in clinical psychology, we support your growth every step of the way.

Salary : $31 - $36