Benefits Coordinator/Intake Eligibility Clerk

Register new patients on RPMS system, verify patient eligibility for clinical services. Assist the patients in obtaining various resources available such as Medi-Cal/Medicare, private insurance, Covered Ca coverage, etc. Inform patients of services available within the clinic.

Specific Duties and Responsibilities:
Assists client(s) or families in the alternate resource application process for social, medical, and dental services with County, State, and Federal agencies.

Notify and update CHS Coordinator and CHS Clerk of status of alternate resource.

Maintain complete and accurate files on clients.

Contact clients via phone call and/or letter as referred from CHS Coordinator, Billing Specialist, or Intake/Eligibility Clerk.

Send out reminder letters to clients regarding progress of applications and needed information.

Maintain contact with Social Service Offices'.

Provides information regarding community services, county programs and tribal assistance programs. Assists clients in obtaining various alternate resources available such as Medi-Cal/Medicare, private insurance, Covered Ca and maintaining disability or other community resource programs.

Obtain information necessary to assist clients in obtaining alternate resources available.

Contacts clients by telephone from list of 30-day letter sent from Intake/Eligibility Clerk.

Keeps weekly counts of clients contacted and the outcome of assistance given to them, and provides this information to Supervisor on a monthly basis for departmental monthly reports.

Maintains strict confidentiality pursuant to HIPAA and the PRHS Personnel Policies and Procedures.

Conduct client interviews for registration purposes and verify eligibility for clinical services.

13. Update all client demographic/resource information for active users on an ongoing basis, or when patient presents for service.

14. Responsible for verifying patient information, tribal certification and insurance billing information.

15. Inform patients of services available within the program and the process in obtaining those services.

16. Assure accuracy of patient documents being submitted to other departments and patient information entered into the RPMS system.

17. Maintain accurate and current files on Non-CHS patients and/or other program information.

18. Acquire all documents required to verify eligibility for services.

19. Collection of fee from clients according to company fee schedule, whenever applicable and depositing to Administration Department.

20. Advise and assist patients with tribal verification process and procedure to apply for alternate resources.

21. Participate in staff development activities and in service training.

Qualifications/Requirements:

Knowledge of California Medi-Cal MediCare, Covered Ca and other alternate resource assistance programs, with one to two years experience working with these programs.

Knowledge of Indian family systems and demonstrates cultural competency with the Pit River Community.

Ability to communicate effectively with staff and clients.

High School diploma or GED required.

Current California Driver's License, with a clean driving record.

Maintain a current CPR card.

Be willing to submit to and pass a pre-employment drug screening test.

Preference will be given to Native Americans in accordance with P.L. 93-638.


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