- Screen clients using PointCare for eligibility in and assist with enrollment/re-enrollment in Covered CA, Medi-Cal, Medicare, MHLA, commercial products, Ryan White, ADAP, and PrEP-AP as well as with the process of accessing Public Benefits.
- Serve as the APLA Health & Wellness point of contact for addressing issues related to health plans that are part of independent physicians associations (IPAs) that APLAHW contracts with, including, but not limited to Health Care LA IPA and Regal Medical Group.
- Documents contacts and maintains files, utilizing Point Care for enrollment allowing them to accurately qualify and enroll patients into coverage, faster.
- Stays current with APLA Health programs.
- Follow up to verify the status of enrollment applications and assist clients who are experiencing problems.
- Complete a comprehensive benefits and qualified health insurance assessment for each client.
- Maintain and update all client records via eClinicalWorks electronic health record system and reviews to verify and ensure data entered are accurate.
- Answer and respond to incoming telephone calls and emails regarding eligibility in qualified health plans and Public Benefits according to agency policy.
- Describe what a summary of benefits document is and where to locate a summary of benefits.
- Collaborate with other programs at APLA Health & Wellness and other service organizations to facilitate the provision of services.
- Maintain an extensive awareness of client resources, both agency-wide and Federally Qualified community-based healthcare organization (FQHC).
- Prepare reports and client records as required to meet APLA Health & Wellness, city, state, and federal program requirements.
- Follow agency policies and maintain agency standards with regards to client confidentiality and HIPAA compliance.
- Effectively communicate with clients/patients in English and Spanish as required per aforementioned job duties. xhuatnn
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Insurance Enrollment Specialist - Los Angeles - APLA Health
Description
APLA Health's mission is to achieve health care equity and promote well-being for the LGBT and other underserved communities and people living with and affected by HIV.
A variety of soft skills and experience may be required for the following role Please ensure you check the overview below carefully.
We provide 20 different services from 15 locations throughout Los Angeles County, including: medical, dental, and behavioral health care; PrEP counseling and management; health education and HIV prevention; and STD screening and treatment.
For people living with HIV, we offer housing support; benefits counseling; home health care; and the Vance North Necessities of Life Program food pantries; among several other critically needed services.
Additionally, we are leaders in advocating for policy and legislation that positively impacts the LGBT and HIV communities, provide capacity-building assistance to health departments across the country, and conduct community-based research on issues affecting the communities we serve.
We offer great benefits, competitive pay, and great working environment We offer: Medical Insurance Dental Insurance (no cost for employee) Vision Insurance (no cost for employee) Long Term Disability Group Term Life and AD&D Insurance Employee Assistance Program Flexible Spending Accounts 11 Paid Holidays 4 Personal Days 10 Vacation Days 12 Sick Days Metro reimbursement or free parking Employer Matched (6%) 403b Retirement Plan This is a great opportunity to make a difference This position will pay $25.
- $28.82 hourly.
Salary is commensurate with experience.
*Please Note: This position is requires Spanish Fluency, an assessment will be required to take prior to moving forward
*POSITION SUMMARY: Under the direction of the Enrollment & Eligibility Manager, and in accordance with HRSA contract requirements, the Enrollment Specialist I assists clients, either directly or through referral, with enrollment/re-enrollment in Covered CA, Medi-Cal, Medicare, and MHLA, as well as with the process of accessing Public Benefits.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
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Enrollment Specialist I
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Medi-cal Enrollment Specialist
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Medi-cal Enrollment Specialist
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Enrollment and Matching Specialist Supervisor
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