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We have are hiring for a Bilingual Eligiblity Supervisor .
Qualified candidates must be bilingual in English and Spanish. The right candidate will be great be a team player with supervisory experience in Patient Eligibility, outreach and Insurance verification!
SOS is proud to be the largest community health center in Orange County to combine wrap-around social services with health care. SOS currently operates six health clinics located in Costa Mesa, Santa Ana, Anaheim, Mission Viejo and Newport Beach; dedicated to improving health outcomes of low-income and at-risk populations in Orange County.
JOB SUMMARY:
The Eligibility Supervisor is responsible for supervising the health centers patient eligibility and pre-registration teams. This position will perform duties within the team; enrolling in coverages, insurance verification, as well as train and supervise the team. This position will be tasked to work with patients and clients of SOS to determine coverage eligibility for such program as MSN, F-Pact, CDP, Medi-Cal or other programs, and assists with completion of applications for sliding fee discount program. Additionally, they will oversee all patient pre-registration including insurance verification and PCP assignment management. In the supervisory capacity this position ensures SOS protocols and procedures are followed. The Eligibility Supervisor acts as liaison and point of contact with Covered California and assists team with completion of applications for good results. This position may assist with internal and external outreach events as assigned. The Eligibility Supervisor works in the team-based model of care.
RESPONSIBILITIES
- Acts as liaison and point of contact with Covered California assuring SOS compliance with required Covered California policies and procedures.
- Represents SOS on the Orange County Certified Enrollment Counselors (CEC) Steering Committee.
- Completes daily work of Eligibility Specialist in support of department.
- Appropriately determines patient eligibility in relation to established program, insurance, or contract standards. Obtains needed forms to document the client’s declaration of California and/or USA residency, and compares the client’s monthly income to a poverty level screening chart.
- Works with walk-ins who arrive with documents for processing regardless of appointment status.
- Scans and indexes records of patient financial eligibility and documents into EHR. Maintains client records as appropriate to evaluate the client’s needs. Compiles data in timely response to requests for information.
- Makes appropriate referrals to the County Welfare Department or respective County/State/Federal agency.
- Maintains a system of prioritizing and monitoring caseload.
- Develops and sustains a positive working relationship with clients and case managers to promote open communication, disseminate information, augment plan of care and enhance client relations
- Responds timely to inquiries and referrals from clients and staff to provide eligibility services.
- Serves as a resource to staff and clients by effectively educating clinical staff, providers, and team members about authorization process as appropriate.
- Utilizes knowledge to coordinate referrals that meet the clients’ needs.
- Maintains records of designated activities and client contact.
- Performs job function in accordance with the departmental policy and procedures.
- Keeps manager informed when problems may interfere with work being completed on time
- Adapts to changes or unusual circumstances to promote cooperation and minimize disruption to working environment.
- Attends monthly CEC meetings and other training sessions as needed.
- Adhere to all client related policies and procedures including confidentiality and HIPAA
- Follows company policies in the performance of the job at all times.
- Completes all specific administrative duties.
- Other duties as assigned by manager.
SUPERVISORY DUTIES:
- Supervises and trains all Eligibility Specialists and Insurance Eligibility Representative on job specific duties including how to enroll in coverages and programs, run eligibility, registration, identify insurance plans, re-assign PCP, etc.
- Supervises and coordinates schedules of team located at the different SOS sites including supervising staff attendance, absences and arranges for staff coverage or emergency coverage as needed.
- Assign workload, develop priorities, and establish work schedules as necessary to ensure timely and accurate completion of tasks.
- Performs chart/account audits to assure required data and documents are uploaded into EHR as required by SOS Policy & Procedures and as required by specific public programs.
- Leads and mentors direct reports to excellent performance; serves as a role model for SOS staff.
- Reviews ADP Timecards for direct reports and ensures compliance and accuracy of time and attendance data for payroll processing, reports corrections payroll processing.
- Oversees staff compliance with handbook policies and procedures related to each position.
- Completes various HR tasks including interviewing and selecting new staff, completion of employee documentation, including recognition, performance evaluations, and corrective action documentation with manager approval.
- Create and maintain effective interpersonal relationships that result in continuous growth in staffs’ professionalism, customer service and work efficiency.
- Create and maintain two-way communications, which encourage collaborative problem solving and decision making.
SKILLS:
- Works well independently and collaboratively with others.
- Communicates and works effectively and sensitively with diverse populations.
- Able to add, subtract, multiply and divide correctly.
- Ability to identify problems and recommend solutions
EDUCATION and / or EXPERIENCE:
- High school diploma or GED required; Associate or bachelor’s degree preferred
- CMAT and CEC certificate must be valid or obtained within 90 days of employment
- Minimum of Two (2) years’ experience in healthcare financial screening, insurance verification and/or related experience
- Two (2) years supervisory experience preferred.
- Excellent verbal and written communication, including use of insurance and medical terminology.
- Bilingual in English and Spanish required.
- Experience and understanding of HIPAA Security and privacy for healthcare workers
- Experience in cultural sensitivity and understanding to all forms of diverse populations including those experiencing homeless.
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What do we offer? A competitive salary and a generous benefits package for our full time team members which includes Health Insurance options covered at 100% or 90% of cost for team members and 50% for eligible dependents; We have group Medical, Dental and Vision, Flexible Spending Accounts, Basic Life insurance/AD &D, Voluntary Life Options, Long Term Disability, 403b Retirement Plan with employer match, Employee Assistance Program, Global Travel Assistance, Supplemental Accident, Critical Illness and Hospitalization plans offered, Tuition Reimbursement Program, 10 Paid Holidays, 10 Paid Vacation days and up to 6 paid Sick days per year.
All qualified candidates will be subject to an employment/criminal background check and must be able to provide proof of required vaccinations which include: Current TB Test, MMR, Annual Flu vaccination, COVID Vaccine/Booster or waiver. SOS will provide vaccines to new employee's if needed at no cost.
Job Req#202307ESUPV
Job Type: Full-time
Pay: $20.00 - $30.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Employee assistance program
- Employee discount
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Retirement plan
- Tuition reimbursement
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Work setting:
- Clinic
- In-person
- Outpatient
COVID-19 considerations:
SOS has a low COVID work policy which requires daily temperature checks, masking, social distancing and other precautions. SOS also provides PPE for all staff members
Experience:
- Insurance verification: 2 years (Preferred)
- Supervisory: 2 years (Preferred)
- Healthcare Financial Screening/Eligilbity: 2 years (Preferred)
License/Certification:
- CMAT (Preferred)
- Certified Enrollment Counselor (Preferred)
Work Location: In person
