Eligibility & Enrollment Specialist

About the Role The Eligibility & Enrollment Specialist helps clients enroll in health insurance programs, registers patients, and supports front desk operations at Indian Health Center of Santa Clara Valley (IHC). This role is integral to the Patient-Centered Health Home model, focusing on outreach, enrollment, and ensuring access to care.

What You'll Do

• Meet with new and established medical clients to inform them about services and enroll them into health insurance programs or any available County coverage.
• Greet patients in waiting room and help them to complete forms.
• Conduct outreach calls to IHC’s American Indian clients and encourage them to come in and receive services.
• Conduct outreach calls and mailings to new medical managed care enrollees.
• Create an incentive system aimed at reducing the number of no-show clients.
• Provide back up to the receptionist and medical records when needed.
• Develop payment plans if needed for clients.
• Compile monthly statistics for the Medical Department’s Board Report.
• Prepare the Eligibility report for registration.
• Make new patient registration packets; confirm appointments; check voicemail daily, follow up with calls and make new patient appointments.
• Maintain schedule for Medi-Cal eligibility worker.
• Assist patients with Medi-Cal applications.
• Assist eligible applicants with the Covered California enrollment process.
• Attend outreach events as needed.
• Participate as a proactive representative of the Patient-Centered Health Home.
• Perform duties utilizing the Team-Based Approach.
• Perform other duties as assigned.

What We're Looking For

• Associate degree in a medical-related field or comparable.
• Minimum of 2 years of experience in a medical setting in a similar position.
• Fluent English; Spanish preferred.
• Knowledge of medical terminology, procedure codes, ICD-9 codes, and medical records handling.
• Trained as Certified Enrollment Counselor for Covered California or willing to complete training within 3 months of hire.
• Vast knowledge of Federal and State health programs, and Qualified Health Plans of Covered California.
• Working knowledge of computer programs such as Microsoft Windows; experience with Electronic Health Records and patient registries.
• Flexibility, initiative, reliability, and creativity.
• Willingness to cross-train for reception and medical records.
• Excellent customer service.
• Knowledge of and ability to relate to the American Indian community and other minority populations.
• Possession of a valid California Driver License, automobile insurance, and a clean driving record; must provide at time of hire.
• Ability to maintain strict confidentiality.
• Ability to function independently and as a team within diverse environments and with a diverse staff composition.
• Demonstrated ability to perform multiple administrative functions simultaneously in an accurate, organized, and efficient manner.
• Ability to multitask and thrive in a fast-paced, constantly changing environment.

Nice to Have

• Preference for qualified American Indian/Alaskan Native candidates in accordance with the American Indian Preference Act.

Compensation & Benefits

• Salary not disclosed; typical benefits not listed in posting.