What are the responsibilities and job description for the Enrollment Specialist position at OLE Health?
POSITION TITLE: | Enrollment Specialist | ||
DEPARTMENT: | Enrollment Services | ||
REPORTS TO TITLE: | Enrollment Services Supervisor | ||
DLSE/FLSA STATUS: () | ____Exempt/Salaried position | __X__Nonexempt/Hourly position | |
SUPERVISORY RESPONSIBILITIES (does this position have direct reports): | YES | NO | |
LOCATION: West Sacramento, CA | |||
SCHEDULE: Full Time; Monday- Friday; 40 hrs./week | |||
PAY RANGE: $27.42 to $33.51 hourly | |||
About CommuniCare OLE Established in 2023, CommuniCare OLE is the result of a union of two health centers with deep roots in their respective communities and reputations for providing high-quality primary care to all, regardless of insurance or ability to pay: OLE Health of Napa and Solano Counties and CommuniCare Health Centers of Yolo County. Building on a legacy established by both organizations in 1972, CommuniCare OLE is a network of federally-qualified health centers with 17 sites across Napa, Solano, and Yolo Counties. It offers comprehensive care, including medical, dental, behavioral health and substance use treatment, nutrition, optometry, pharmacy, care coordination, referrals, and enrollment assistance to more than 70,000 individuals, and no one is turned away due to lack of insurance, immigration status, or ability to pay. Many services are offered outside of its sites, including mobile health, home visiting, and community and school-based programs.
BENEFITS
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JOB SUMMARY/OVERVIEW: The Enrollment Specialist is responsible for welcoming new and existing members of the community with facilitating patient access to affordable quality health care. Enrollment specialists assist with determining eligibility for health coverage programs or plans.
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CommuniCare OLE provides an inclusive workplace that promotes and values diversity and life experience.
CommuniCare OLE encourages people of all backgrounds to apply including, but not limited to, Black, Indigenous Peoples,
people of color, immigrants, refugees, women, LGBTQIA , people with disabilities, veterans, individuals of
all ages and religions, and individuals who have been affected by the legal system.
YOU ARE WELCOME HERE.
***The following reflects requirements and essential functions of this position but does not restrict tasks that may be assigned. Essential functions include basic job duties, core elements, or fundamental responsibilities that an employee must perform to hold the position. Employees must be able to perform these essential functions with or without reasonable accommodation (accommodation may be requested). Duties and responsibilities are not all-inclusive, and they may be assigned or reassigned to this job at any time, due to reasonable accommodation or any other reason. ***
| College degree or high school diploma with 2 years related work experience |
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ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
1. | Knowledge of Federally Qualified Health Centers and the key health center principles and guidelines |
2. | Knowledge of EHR System |
3. | Knowledge of Medi-Cal and self-sufficiency program eligibility guidelines |
4. | Ability to assess needs and ask appropriate questions to obtain needed information for enrollment assistance |
5. | Knowledge of in-reach strategies to capture uninsured patients and enroll them in coverage programs |
6. | Responsible for creating and updating patient records in electronic health record |
7. | Responsible for greeting patients and driving a positive patient customer service experience by assessing all patient needs |
8. | Responsible for extensive knowledge of programs/insurances & access/eligibility guidelines & applications |
9. | Answer any questions regarding Communicare OLE resources, sites and services |
10. | Responsible for working with all departments to identify uninsured patients who need specialty care and need to apply for charity care at hospitals or other healthcare facilities. |
11. | Conducts chart review for patients seeing providers in Perinatal and Primary Care to determine clients who need assistance with their health coverage. |
12. | Responsible for producing regular reports on activity and outcomes |
13. | Works with County eligibility representative to assist patient and their families with completing and submitting the appropriate health insurance application/s, including assistance with gathering necessary documents |
14. | Advocates for patients to out-stationed county Eligibility Workers for completion of application process when appropriate. |
15. | Runs reports of billing claims for uninsured patients and screens for coverage programs, if enrolled adds payor as necessary. |
16. | Act as a resource to all clinic staff regarding third party payor programs and public charge and immigration issues relating to health care benefits. |
17. | Assist in training staff on eligibility requirements, application process, and benefits of enrollment in third party programs and health care coverage. |
18. | Attends health fairs, meetings, and other community events to inform the community about the various health care coverage options. |
19. | Responsible for precise data entry of patient information into tracking systems in a timely manner |
20. | Maintains patient renewal requirement data, contact families before their health plan renewal is due to prevent gaps in coverage and/or loss of insurance |
21. | Assists patients with accessing financial and/or community resources when referred to outside medical providers or medical service |
22. | Attends meetings and trainings as needed to maintain up to date knowledge of services in Communire OLE, State application assistance rules/guidelines, and community resources |
23. | Performs other duties as assigned. |
Salary : $27 - $34