Medi-Cal Eligibility Services Coordinator

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Regular Full time Clerical Tarzana, CA, US

3 days ago Requisition

Salary Range: $29.58 To $37.02 Hourly

Position Title
:
Medi-Cal Eligibility Services Coordinator

Department
:
Admission

Reports To
:
Supervisor of Admissions

POSITION SUMMARY

The Medi-Cal Eligibility Services Coordinator is responsible for leading TTC’s strategy to assist patients in achieving, maintaining, and re-establishing Medi-Cal coverage. This position oversees the full lifecycle of Medi-Cal eligibility from initial application and onboarding through semiannual recertification/redetermination cycles and change-of-circumstance processing.

The Medi-Cal Eligibility Services Coordinator ensures all eligibility and redetermination workflows comply with state and federal mandates, this role strictly enforces TTC's compliance with DHCS Authorized Representative (AR) rules and conflict-of-interest requirements.

Benefits Package

• Medical Insurance
• Vision Care Plan
• Life Insurance
• Paid Holidays
• Flexible Spending Account (FSA)
• Paid Vacation Time
• Sick Time
• 401(k) Retirement Plan
• Competitive wages
• Stability and career advancement
• Continuing Education Opportunities

CATEGORIES OF DUTIES

1. Medi-Cal Initial Eligibility & Continuous Coverage Management

• Lead staff in screening patients for Medi-Cal eligibility and facilitating the completion and submission of the Single Streamlined Application (SSApp) via Benefits Cal and DPSS channels.
• Ensure application and eligibility workflows support timely determinations, low-barrier enrollment, and compliance with applicable federal and California requirements.
• Develop and maintain proactive processes to reduce administrative or procedural loss of coverage and minimize gaps in patient eligibility.
• Oversee TTC’s operational workflow for required Medi-Cal redeterminations and renewals, including applicable semiannual cycles.
• Coordinate with county eligibility workers to maximize ex-parte renewals and resolve eligibility issues before coverage is interrupted.
• Oversee patient completion and signing of Medi-Cal Renewal Forms (e.g., MC 210 RV) and Statement of Facts forms (SAWS
  2). Ensure income, household, and activity verifications are submitted within state-mandated time frames.
• Enforce procedures following procedural discontinuances within the 90-day cure period, submitting required documentation promptly to rescind notices of action without requiring a full re-application.
• Ensure required changes in income, household size, or address are reported to the Department of Public Social Services (DPSS) within statutory deadlines, establishing new 6-month renewal dates upon completion of redeterminations as specified by DHCS guidelines.
• Audit and respond to county Notices of Action (NOAs) regarding denials, share-of-cost changes, or discontinuances
• Assist patients with State Fair Hearing requests and coordinate or provide Authorized Representative support during the appeals process, as permitted.
• Promote patient understanding of eligibility decisions, appeal rights, and available options for maintaining coverage.

4. Authorized Representative (AR) Implementation & Compliance

• Enforce mandatory completion and patient signature of the Appointment of Authorized Representative form (MC 382) prior to taking official action on a case.
• Oversee completion of the Authorized Representative Standard Agreement for Organizations (MC 383), designating up to three authorized TTC employees per patient file.
• Enforce strict compliance with the Political Reform Act and DHCS rules by delivering written conflict-of-interest disclosures to patients prior to acting…