"Insurance & Enrollment Specialist (UH- Health Family Care Center)"

Department: Clinic Enterprise

Salary: 43,000-54,800 (Commensurate with Experience/Education)

Description: Determines applicant eligibility for third party reimbursement, processes data necessary for admission of new patients into health services, ensure proper coding for insurance billing, and handle inquiries from prospective applicants and patients.

1. Conducts eligibility for clients following process and guidelines specific to each program.
2. Participates in client recruitment and education in the community regarding services, programs and eligibility.
3. Ensures that clients do not have another payer source such as Medicaid, Medicare, ADAP, and any other third-party insurance.
4. Registers clients into applicable systems.
5. Completes all necessary paperwork and performs data entry of eligible clients into electronic system.
6. Maintains up-to-date and orderly eligibility files and conducts renewal eligibility as required by each program.
7. Confirms eligibility appointments with clients and schedule appointments with potential clients.
8. Sets initial service appointments once eligibility has been determined.
9. Provides clients with list of required eligibility documentation.
10. Works with administration to ensure appropriate collection of data for financial, operations, compliance, and quality reporting.
11. Participates in quality improvement initiatives.
12. Performs other job-related duties as assigned.

MQ: Requires the ability and knowledge for analysis and interpretation of procedures, policies and practices attainable through specific education and/or training programs in a specialty or technical field. Advanced vocational or electronic skills or a basic knowledge of a professional field is required. An Associate's degree or certification/licensing in a technical specialty program of over 18 months and up to 3 years duration are characteristic of this field. Requires a minimum of three (3) years of directly job-related experience. Preferred: FQHC or Community Health Center experience.

Additional Job Posting Information: - Department is willing to accept education in lieu of experience. - Department is willing to accept experience in lieu of education.