Eligibility Specialist

Marillac Health is hiring an Eligibility Specialist for our Grand Junction Location!

Job Summary: Marillac is a Federally Qualified Health Center (FQHC). This position provides eligibility screening for its sliding fee discount program (SFDP), a key component of its FQHC status. This position also provides outreach and enrollment services via the Colorado healthcare exchange. Becoming a Certified Health Coverage Guide, which will be supported by Marillac, will be a condition of employment.

Essential Functions:

• Interviews patients to determine eligibility for clinic services and secures information relative to patient’s financial and household status. Uses established guidelines to determine eligibility and patient fees and discounts. Uses common sense in formulating questions about eligibility.

• Communicates with patients both verbally and in writing about community programs they may be eligible for. Communicates with patients and their families in a caring, courteous, and respectful manner. Exhibits the ability to be assertive and decisive when faced with situations that demand these abilities.

• Ensures paperwork is complete and complies with Marillac policies and all audit guidelines. Participates in ‘audits on demand. Displays understanding of how eligibility process works. Maintains good records about patients needing updates.

• Provides clear explanations when patients are found to be ineligible. Works closely with clinic staff in educating why patients are/aren’t eligible for services. Works closely with case managers to make the best referrals for patients found to be ineligible.

• Orients patients to clinic services they are eligible for. Uses language and methods of communication to enhance patients’ ability to understand services, consents, and rights and responsibilities. Acts as an ongoing resource to patients with questions about clinic services. Assists staff in updating patient registration materials and eligibility forms.

• Obtains medical release of information for new patients with chronic health problems. Operates with staff on a “need to know” basis regarding information obtained during eligibility process.

• Actively participates in clinic Continuous Quality Improvement activities and identifies areas that could benefit from Process Improvement activities. Ensures that approved changes regarding eligibility and patient orientation are carried out. Assists in the writing of policies and procedures as needed and as agreed upon by supervisor.

• Performs outreach and enrollment services on-site and at community events. Assists patients to enroll in Medicaid and insurances offered on the Colorado healthcare exchange.

• Prepares daily deposits from money received through the mail and from medical/dental front desks. Makes sure amount deposited matches the amounts recorded in EHR/EDR.

• Maintains strictest of confidentiality.

• Participates in professional development activities.

• Performs other duties as required by supervisor.

Competencies:

• Customer Service

• Computer skills including Microsoft Office Suite

Required Education/Experience:

• High School Diploma or equivalent required.

• Certified Health Coverage Guide. (Can be secured subsequent to being hired.)

Preferred Education/ Experience:

• One-year related experience.

Additional Eligibility: Must be current or willing to be vaccinated for the following.

• TDAP (up to date booster)

• MMR series

• Varicella

• HEP B series

• Flu Shot

• TB Screening

• COVID (recommended)