Eligibility Enrollment Specialist

Reports to: Outreach/Enrollment Manager

Position Classification: Non-Exempt

Work Location: All FamilyCare Sites

Physical Requirements:

The employee is regularly required to talk and hear. The employee is regularly required to sit, stand, and walk. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. The employee must occasionally bend and stoop. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to focus.

Qualifications:

High School Graduate or equivalent. Excellent verbal skills, the ability to work with a variety of people of various backgrounds, and organizational skills essential. Basic knowledge of computer and medical terminology are necessary .

Basic Function:

Provide screening and eligibility assistance to FamilyCare patients and the community.

Duties and Responsibilities:

• Screen and assist patients with enrollment into available programs, including Sliding Fee (SFS), Community Access Program (CAP), Children's Health Insurance Program (CHIP), Medicaid/Medicare and The Marketplace.
• Identify and assist with other patient and family needs, such as where and how to obtain eye glasses, dental treatment, clothing, housing, and various educational programs.
• Maintain a close working relationship with Department of Health and Human Resources (DHHR) and other community organizations.
• Distribute information and materials regarding services to the community and local businesses.
• Participate in events, health fairs, and other activities as a representative of FamilyCare. May be outside of normal work week. (Evenings and/or weekends). 
• Track and maintain current income and program requirements needed to determine eligibility for services.
• Provide statistics and enrollment data, as needed.
• Deliver completed forms to the DHHR and other agencies in timely manner.
• Follow-up and meet with patients to clarify and assist with the completion of applications.
• Make calls to patients on Medicare to see if we can get them enrolled with Medicaid as a secondary insurance to absorb some of the cost.
• Assist patient when applying through the Marketplace. If it is a Special Enrollment Period, assist the patient with proper documentation to validate the SEP and upload or provide correct mailing information.
• Call those patients who have recently lost their Medicaid or insurance to assist them with getting re-enrolled.
• Make calls to the Medication-Assisted Treatment Program patients to see if they are eligible for Medicaid enrollment.
• Call uninsured patients to let them know about the assistance programs that are offered at FamilyCare.