Medi-Cal Eligibility Coordinator

The Eligibility & Coverage Advocate is the liaison between participants and the WelbeHealth center team and is responsible for assisting enrolled participants in maintaining eligibility for state and federal benefits they are entitled to such as SSI, Medicaid, and Medicare. The Eligibility & Coverage Advocate will support the Eligibility & Reconciliation (E&R) team to ensure accurate and timely resolution of eligibility issues and functions with minimal direction and prioritize daily scope of work requests, inquiries, manage turnaround times and items that need escalation.

 

Essential Job Duties:

• Proactively identifies participants coming up for MediCal redetermination.

• Educate and assist participants in the completion of all necessary forms and ensure appropriate signatures are obtained.

• Conduct visits to participants home when necessary to complete forms.

• Assist with obtaining all documentation required for eligibility determination/redetermination.

• Complete and file applications. Initiate and maintain proper follow-up with participant, center staff and government agencies to ensure timely processing and completion of all mandated applications and accompanying documentation.

• Maintain a strong working relationship with the Department of Public and Social Services (DPSS) to ensure compliance with DHCS and CMS policies and procedures.

 

Job Requirements:

• High School Diploma or Equivalency

• Minimum three years of relevant Medi-Cal/Medicaid enrollment experience, including share of cost, spousal impoverishment protections and appeals processes.

• Experience working directly with the county DPSS submitting, managing, and appealing Medi-Cal enrollments.

• Demonstrate in-depth experience with complex Medi-Cal enrollment case management and knowledge of Medi-Cal rules, processes, and practices.

• Bilingual (Spanish/English) strongly preferred.

• Strong personal interaction skills, comfortable speaking to seniors in a caring and comforting manner.

 

Benefits of Working at WelbeHealth: Apply your healthcare expertise in new ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for.

· 401k + employer match

· Medical insurance coverage (Medical, Dental, Vision) starting day one of employment

· Work life balance – we mean it! 17 days of personal time off (PTO), 12 holidays observed annually, sick time

· And additional benefits

 

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Last updated on Aug 20, 2024