Behavioral Health Enrollment Specialist
Job Details
Entry
The David Geffen Center - Los Angeles, CA
Full Time
High School
$20.00 - $23.91 Hourly
None
Day
Admin - Clerical

POSITION SUMMARY:

Under the direction of the Enrollment & Eligibility Manager, and in accordance with HRSA contract requirements, the Behavioral Health Enrollment Specialist assists clients, either directly or through referral, with enrollment/re-enrollment in Covered CA, Medi-Cal, and Medicare, as well as with the process of accessing Public Benefits. The position also provides administrative support to the Clinical Intern Training Program.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Screen patients using PointCare for eligibility and assist with enrollment/re-enrollment in Medi-Cal, Medicare, Commercial products as well as with the process of accessing Public Benefits.
  • Follow up to verify the status of enrollment applications and assist patients who are experiencing problems.
  • Provide basic information about Behavioral Health Services to patients. Explain the various requirements and criteria to potential patients.
  • Conduct initial meeting with potential patients to establish eligibility and insurance coverage. Collect required documentation from patients including verification of income, residency, and proof of insurance coverage.
  • Verify patients insurance with various health plans. Communicate information regarding coverage or optional sliding scale fee structure as appropriate. Collect fees and co-pays for Geffen clinic, and submit to Finance with appropriate documentation in accordance with Finance Policies.
  • Coordinate assignment of new patients for intake assessment to appropriate department staff or clinical interns. Maintain waiting list as needed. Maintain system to track staff and intern caseload.
  • Assist patients with access to APLA support groups; provide referrals to support groups throughout LA County.
  • Set up new patients in programs electronic health record, eClinicalWorks (eCW). Ensure that patients seen by the program are entered accurately in eCW including insurance coverage and co-pay/self-pay requirements. Ensure that patients are shown as checked out upon completion of service delivery to facilitate insurance billing.
  • Collect and organize data for completion of monthly contract reports for all funding sources. Respond to calls for data as needed for West Hollywood and/or external funding sources.
  • Collaborate with other programs at APLA Health & Wellness and other service organizations to facilitate the provision of services.
  • Complete DMH COS forms for patient contact as appropriate. Coordinate monthly entry of departmental COS data forms into the DMH data collection system. Provide monthly report of COS service delivery to Controller.
  • Maintain patient charts, including the filing of all required documentation and/or scanning of appropriate documentation into eCW.

 

OTHER DUTIES MAY BE ASSIGNED TO MEET BUSINESS NEEDS.

REQUIREMENTS:

Training and Experience:

High school diploma required; some college experience preferred; administrative experience required; experience working with people with HIV/AIDS and behavioral health problems preferred. Experience with grant funding reports is preferred; bilingual English/Spanish required.

 

Knowledge of:

Microsofts Word and Excel; administrative workflow procedures, filing systems; HIV disease and related issues; bilingual (English/Spanish) proficiency; culturally sensitive and appropriate intervention and assessment techniques.

 

Ability to:

Respond sensitively to people from a wide variety of backgrounds and with diverse needs including patients staff and volunteers; effectively address patient complaints/concerns; communicate in both written and spoken English and Spanish; format, proofread and edit written materials; operate word processing and data entry on a personal computer; perform tasks quickly and thoroughly; maintain updated files; follow directions; work well under pressure; meet necessary deadlines; work independently.

 

WORKING CONDITIONS/PHYSICAL REQUIREMENTS:

This is primarily an office position that requires only occasional bending, reaching, stooping, lifting and moving of office materials weighing 25 pounds or less. The position requires daily use of a personal computer and requires entering, viewing, and revising text and graphics on the computer terminal and on paper.

 

SPECIAL REQUIREMENTS:

Must possess a valid California drivers license; proof of auto liability insurance; and have the use of a personal vehicle for work related purposes. COVID vaccination is required and APLA Health will consider accommodations for disability- and religious-based reasons.

 

Equal Opportunity Employer: minority/female/disability/veteran.

 

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