Benefit Enrollment Specialist

Benefit Enrollment Specialist

Full-Time | Hourly

Acute Care Clinic

We’re committed to compassionate care for all. Our patients. Our employees. You.

At La Clinica, we love our patients and enthusiastically treat them with the same care, respect, and dignity that we would our friends, family, and neighbors because that's who they are. If this appeals to you, La Clinica might be the right place to build your career. We’re looking for the right team members to treat our patients with this level of care.

We extend our commitment to compassionate care to our employees as well. We invest in our employees' lives through competitive pay, comprehensive benefits packages, easy access to wellness, personal and professional

The Benefit Enrollment Specialist is responsible for evaluating the patient’s financial circumstances and providing information regarding potential resources to patients. The BES will assist patients with the submission or applications, obtain required verification, document identity and citizenship according to DMAP (Division of Medical Assistance Programs) standards, follow up with patients to assure timely submission and act as liaison with DMAP to eliminate barriers to eligibility determinations. 

Accountabilities Include: 

Performs Essential Job Duties 

• Maintaining regular, consistent, and predictable punctuality and attendance, including being available, accessible, and able to complete all required essential functions and assigned job tasks onsite as directed during your regularly assigned schedule or your assigned site(s) normal business hours.  
• Demonstrates knowledge of all aspects of medical assistance programs available through the Department of Human Services. 
• Evaluates patient’s circumstances and assists with accessing the benefit most advantageous to the patient’s family circumstances. 
• Assists patient with the completion of the application process, including assistance in obtaining necessary documents, and submission of applications to the OHA Central unit or other program related processing center. 
• Follows up on pending applications and update EPIC with insurance status. 
• Works with billing department to identify potential covered charges that can be billed to DMAP or other insurance carrier. 
• Meets in person, with patients referred by reception or other clinic staff. 
• Enrolls patients via-phone or virtually. 
• Determines eligibility for patient applying for CCARE and SCREENWISE and documents eligibility efforts in EPIC. 
• Utilizes EXCEL and/or ACCESS program to track all patients potentially eligible for OHP, CHIP, and CAWEM. Provides monthly status reports to Management. 

• Assists with the development and implementation of strategies to reach target populations; aid these groups with accessing medical benefits to support their ability to access ongoing medical care. 
• Represents La Clinica at meetings and conferences, as directed. 
• Maintains the confidentiality and privacy of patients, staff and the organization. 
• Communicates effectively La Clinica’s mission and values to staff and clients. 
• Participates in Migrant Camp Outreach Efforts. 
• Follows workflows that result in capturing activities to meet patient engagement standards as outlined in the APCM program. 
• Supports the development and implementation of standard workflow. 
• Responsible for outreach efforts to ensure continuation of OHP eligibility and engagement in La Clinica services. 
• Provides monthly status to direct supervisor. 
• Facilitate team meetings. 
• Conducts chart audit reviews. 
• Other duties as assigned. 

Expected abilities: 

• Must be able to multitask, work effectively with team members and at times work independently with minimal supervision 
• Will adhere to team agreements as well as assist with revisions as necessary 
• Will accept the responsibility for educating and adhering to the policies and procedures of La Clinica and its associated departments and programs 
• Will attend and participate in relevant department and clinic meetings 
• Assist in the ongoing improvement of the clinic  

Education and/or Experience: 

Required: 

• Minimum: High School Diploma 
• Excellent interpersonal communication and problem-solving skills 
• Skills to intervene and promote reconciliation, compromise and positive outcomes in difficult interactions 
• Basic knowledge of Excel, SharePoint and Office Suite 
• Bilingual in Spanish and English
• Skilled at using electronic health records as applicable to area of work (EPIC)  

Preferred: 

• Basic knowledge of adult learning models  
• Six months of experience in related field or training
• Skilled at using electronic health records as applicable to area of work (EPIC)  

Equity Statement:

At La Clinica, we commit to engage everyone in a welcoming, respectful, and loving way and to maintain the dignity and value of all people above everything else. These standards align with our organization’s vision of absolute excellence, open-hearted community, and well-being for all.

For more information, please visit our website at: https://laclinicahealth.org/patients/approach/

Applications will be reviewed by the appropriate Department for interview; those selected must be able to provide proof of legal right to work in this country. La Clinica is a drug free work environment. Equal Opportunity Employer. La Clinica complies with the Americans with Disabilities Act. If you consider yourself disabled and desire assistance in the application process, please contact the Human Resources Department.