POSITION OVERVIEW:
The Onboarding & Enrollment Representative is responsible for assisting prospective patients in a culturally sensitive manner to achieve patient goals through engagement, education, and promotion of our services. They will provide enrollment assistance to uninsured children and adults to access subsidized, low-cost, and free health insurance programs through Medicaid, the Children's Health Insurance Program (CHIP), the hospital's free care program(s), and the health center's sliding fee scale. Additionally, they will participate in patient education activities, distribute outreach materials to raise awareness about coverage options and promote the mission and services of the G.F.H. organization. The Onboarding and Enrollment Specialist will also collaborate with local organizations to build awareness, spur enrollment, and build referral linkages. Lastly, the Representative will educate patients about their healthcare coverage options.
DUTIES/RESPONSIBILITIES:
The Onboarding & Enrollment Representative plays a crucial role in assisting patients with their healthcare needs. They provide resources and assistance to referring physicians, patients, and caregivers to access clinical and supportive care services offered within G.F.H. and in the community. The representative also stays updated on ongoing changes to the public healthcare system and communicates this information to patients and partners while maintaining expertise in eligibility, enrollment, and program specifications.
The responsibilities of this position include ensuring the accuracy and completeness of the assigned provider's schedule, gathering and uploading any necessary documentation required by HRSA or regulations, verifying patient details such as address and insurance, and contacting patients to update any unverified information at least 24 hours before their appointment. This position is also responsible for ensuring the accuracy of all documentation attached to the patient's account and handling referrals or pre-authorizations. Furthermore, this position will collect essential UDS data as required per our HRSA federal funding.
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Assist patients with completing financial assistance applications and application renewals based on established policies and procedures and maintain documentation to support each process step to application approval or denial.
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Complete the registration process for new patients and annual renewals, which includes mandatory UDS data measurements. Using online systems, validate insurance eligibility and verify patients' insurance status. Collect and scan all necessary documentation for the patient's account.
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Screen patients to determine their eligibility for specific programs based on established criteria. This includes programs such as G.F.H. slide discounts and payment plan options. All necessary documentation must be readily available from the patient's account.
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Obtain Prior Authorization from a Managed Care Plan for necessary services, including OB patients, behavioral health, and other specialties, and Document all follow-up contact efforts.
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Respond efficiently and timely to all patient and provider staff needs and inquiries.
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The O&E representative will ensure excellent customer service to all G.F.H. stakeholders.
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Ensures HIPAA compliance by maintaining strict confidentiality of all patient data and E.M.R.
Contact patients via phone calls, text, postcards, or letters for:
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Medical re-determination
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Initial Health Assessment
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Clinical Care Measures
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Managed care patients to return for a clinic visit
Remains informed of:
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Current legal and regulatory changes related to the scope of practice
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Specific programs/payors, insurances accepted, and services offered at G.F.H.
All other duties as assigned
MINIMUM QUALIFICATIONS:
A high school diploma (or G.E.D. equivalent) is required for this position.The ideal candidate should have exceptional organizational, writing, and verbal communication skills and be computer literate, with proficiency in Word, Excel, & PowerPoint. FQHC experience is highly preferred, and excellent analytical skills are necessary. The candidate should be motivated to take the initiative to ensure the completion of all tasks performed thoroughly and accurately. They should also be committed to providing high-quality healthcare for disadvantaged and underserved communities, and willing to adapt to changes concerning the agency's growth and expansion. The ability to function self-sufficiently, requiring little supervision, is a must.
