The Enrollment and Eligibility Specialist plays an important role in helping children and families enroll in the Medi-Cal Program. In addition to helping families complete and submit the on line applications, the Enrollment and Eligibility Specialists also keep families informed about program changes and help them maintain their health coverage. They also help families who do not qualify for the Medi-Cal Program by referring them to other available programs. Additionally when not performing enrollments, the position is responsible for the efficient and effective scheduling of site appointments. Answer incoming telephone calls from patients and physician offices calling to schedule Medical, Dental, CPSP, Behavioral Health and Health Education appointments. Plans, organizes, monitors and reports as necessary. Confirms appointments per established protocol. Secures patient information for charting, billing and record keeping purposes. Ensures that established information is obtained in order to pre-register patients.
This non-exempt position is directly responsible for supporting the sites by improving UHC's central operations through new enrollments and recertification's, monitoring errors, and correcting issues. The Enrollment and Eligibility Specialist works closely with the Enrollment Specialist Supervisor to this end and is familiar with the screening and evaluative processes necessary to determine a patient's eligibility for Medi-cal, (including Medi-cal Dental and presumptive eligibility), Family PACT, CDP & Healthy Families.
EDUCATION AND LICENSE/CERTIFICATION: