Eligibility Specialist - Winslow - Family Medicine

Introduction

Love where you work as much as you love where you live by joining Elk Ridge Community Health.

The Eligibility Specialist (Elk Ridge) is responsible for performing administrative duties and processing which include the determination of eligibility for services and application assistor in support of Elk Ridge Community Health services and its varied operations. The incumbent in this position will possess and demonstrate an advanced and comprehensive understanding of community, government, and private social services/agencies and programs and serve as an informational resource to clients and staff members.

This includes eligibility requirements and procedures to effectively support the recruitment, registration, enrollment, and retention of consumers to the ACA Marketplace, AHCCCS, or discount programs; as well as referrals to social services or agencies.

An Eligibility Specialist (Elk Ridge) works with intermittent supervision and review, and any work problems involving departures from standard policies, interpretations, or procedures are reviewed with the supervisor, or applicable agency representative for resolution.

The primary goal of the Elk Ridge Community Health Eligibility Specialist (Elk Ridge) is to support Elk Ridge’s Mission of providing comprehensive, quality health care that is affordable and accessible to all who may have healthcare needs, by successfully performing the primary essential functions.

The following functions and responsibilities will contribute to Elk Ridge Community Health to achieve its KEY RESULTS:

• Serve as a contact point and liaison to internal departments and staff for problem-solving and in-service training related to eligibility services.
• Facilitates internal and external informational presentations to community groups or individuals on Affordable Care Act, AHCCCS, and other eligibility services.
• Performs public speaking on eligibility services to large and small groups in informal or formal settings;
• Creates presentations and materials that will meet the Center for Medicare/Medicaid Systems (CMS) guidelines and approval.
• Supports El Rio Health by participating in community events that promote good health and which contribute to a broader awareness and understanding of the governmental and private healthcare programs or services available to the community.
• Completes administrative processing of operational activity into program systems or spreadsheets to support effective and timely tracking, reporting, and invoicing of application completion and production.
• Gains and maintains proficient skill with all organizational or agency operating systems and programs by adapting to changing requirements and successfully learning and demonstrating new skills in response to system and program improvements or upgrades.

• Maintains a clean, safe, and hygienic work environment in compliance with all Policies and Procedures including but not limited to work areas, workstations, examination rooms, hand washing, infection prevention and control etc. for this position.
• Demonstrates an understanding of and proficiency with the application of all compliance and reporting requirements respective to Joint Commission Certification (JCC) standards.

• Performs all assigned tasks, responsibilities, and assignments supporting departmental operations within established periods; meeting established rates of performance for the quality and quantity of work for the position; and demonstrating the highest levels of professionalism, quality, efficiency, and accuracy in the employee’s job performance that exhibits the highest…