Top 86 Eligibility specialist Jobs in Fresno County Ca

Eligibility Specialist
INNOVATIVE INTEGRATED HEALTH —Fresno, CA
- $20 - $24 an hour
- Full-time
- Spanish
- Microsoft Outlook
- Writing skills
- Health savings account
- Health insurance
Client Relations Specialist
Maxim Healthcare —Fresno, CA
- $23 an hour
- Full-time
- Microsoft Excel
- High school diploma or GED
- Case management
- Profit sharing
- Commuter assistance
Quick Apply
Payroll Specialist
BBSI —Fresno, CA
- $27 - $32 an hour
- Full-time
- Background check
- Microsoft Outlook
- Up to 50% travel
- Commuter assistance
- Health savings account
Quick Apply
Regulatory Compliance Specialist
Related —California
- $75,000 - $90,000 a year
- Full-time
- 5 years
- Mid-level
- Real Estate License
- Health savings account
- AD&D insurance
Underwriting Specialist OR Executive Underwriter - Large Contract Surety
Zurich Insurance Company Ltd. —California
- $75,000 - $165,000 a year
- Full-time
- Hybrid work
- Mid-level
- High school diploma or GED
- Business development experience
Enrollment Specialist
United Health Centers of the San Joaquin Valley —Fresno, CA
- From $21 an hour
- Online Application
- Spanish
- Office
- High school diploma or GED
- Paid holidays
- Health insurance
Admission Specialist
WESTCARE CALIFORNIA INC —Fresno, CA
- $28 an hour
- Full-time
- Bilingual
- CPR Certification
- Current TB test
Quick Apply
9d
Bilingual Community Engagement Specialist (Remote, Full Time - Weekends)
Pair Team —Fresno, CA
- $25 an hour
- Weekends as needed
- Remote
- Background check
- Spanish
- English
- Dental insurance
- 401(k)
Quick Apply
Specialist: Seasonal, Part-time
Apple —Fresno, CA
- $22.00 - $28.88 an hour
- Part-time
- Entry level
- Employee stock purchase plan
- Health insurance
Billing Specialist
WESTCARE CALIFORNIA INC —Fresno, CA
- $24 an hour
- Full-time
- CPR Certification
- Current TB test
- Mid-level
Quick Apply
HEALTH SERVICES SPECIALIST (SAFETY)
Department of State Hospitals —Fresno County, CA
- $10,484 - $12,497 a month
- Overtime
- Current TB test
- RN License
- Mid-level
11d
Historic Preservation Specialist
City of Fresno —Fresno, CA
- $7,245 - $8,776 a month
- Full-time
- Mid-level
- Driver's License
- Bachelor's degree
10d
Compliance Specialist
GSF Properties Inc. —Fresno, CA
- $23 - $25 an hour
- Monday to Friday
- Microsoft Outlook
- Mid-level
- Office
- Paid holidays
- Health insurance
Quick Apply
10d
Member Specialist
Sam's Club —Fresno, CA
- $19 - $27 an hour
- High school
- Merchandising
- Continuous improvement
- Paid jury duty
- Disability insurance
Information Technology Specialist
US Internal Revenue Service —Fresno, CA
- $106,437 - $163,062 a year
- Online Application
- Hybrid work
- Background check
- 18 years or older
- Pass drug screening
3d
Billing System Specialist
City of Fresno —Fresno, CA
- $4,756 - $5,705 a month
- Full-time
- Mid-level
- Office
- Finance
2d
Family Services Specialist
Community Action Partnership of San Luis Obispo —Fresno, CA
- $19.20 - $22.75 an hour
- Email
- Bilingual
- Bachelor of Science
- Driver's License
Quick Apply
Experienced Energy Savings Assistance Program Specialist
Borgen's Construction,Inc. —Fresno, CA
- $75 - $120 an hour
- Contract
- Background check
- Spanish
- Computer literacy
- Opportunities for advancement
- Flexible schedule
Quick Apply
11h
Human Resource Expert
Target —Fresno, CA
- From $18.25 an hour
- Part-time
- Fair chance
- Communication skills
- Entry level
- Flexible schedule
9d
Floating Compliance Specialist
GSF Properties Inc. —Fresno, CA
- $24 - $26 an hour
- Monday to Friday
- Microsoft Outlook
- Mid-level
- Driver's License
- Paid holidays
- Health insurance
Quick Apply
10d

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Eligibility Specialist

INNOVATIVE INTEGRATED HEALTH -
Fresno, CA

Apply Now

Job Details

Full-time
$20 - $24 an hour

Benefits

Health savings account
Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Employee assistance program
Vision insurance
Employee discount
Life insurance
Referral program
Paid sick time

Qualifications

Spanish
Managed care
Managed care organization experience

Full Job Description

Who We Are

PACE by IIH is empowering senior participants to age at home with dignity through personalized, comprehensive care plans that deliver high-quality health and human services along with strong community support. Through an interdisciplinary and participant-centered model of care, PACE by IIH is committed to improving quality of life, promoting independence, and providing compassionate support tailored to the unique needs of each participant. Our team works collaboratively to deliver innovative, community-based healthcare solutions that allow seniors to remain safely and comfortably in their homes while receiving the care and services they need to thrive.

Benefits

401(k)
Dental insurance
Employee assistance program
Employee discount
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid sick time
Paid time off
Referral program
Retirement plan
Vision insurance

Job Summary
Under the supervision of the Eligibility Supervisor, the Eligibility Specialist is responsible for resolving accounts receivable pertaining to participants’ eligibility and enrollment issues. The Eligibility Specialist will ensure the goals and objectives of the Finance department are achieved while abiding to state and federal rules and regulations. This position is expected to be highly collaborative by working closely with other departments such as the Claims, Intake, and Social Work teams to remedy any eligibility/enrollment issues.

Essential Job Functions
Duties include, but are not limited to:

Monitor participant eligibility/enrollment status as provided by state and federal agencies such as the Department of Health Care Services (DHCS) and the Center for Medicare and Medicaid Services (CMS)
Track eligibility/enrollment changes daily for documentation purposes
Track Medicare eligibility dates for all participants and work with Intake to ensure timely enrollment
Assist with retrospective and prospective enrollment/disenrollment efforts
Initiate and maintain proper follow-ups with DHCS and CMS to ensure timely processing and completion of all mandated applications and accompanying documentation Maintain knowledge of eligibility and enrollment requirements for individuals participating in the Program of All-inclusive Care for the Elderly (PACE), including but not limited to out-of-area issues, Share of Costs (SOC), Primary Aid Codes, and excluded benefits
Update enrollment/eligibility databases and other tracking spreadsheets including but not limited to Medi-Cal/Medicare eligibility issues
Assist all departments in confirming/verifying participant eligibility/enrollment status for internal and external inquiries for coordination of care
Attend and participate in staff meetings, in-services, projects, and committees as assigned
Adhere to and support the company practices, procedures, and policies including assigned break times and attendance
Accept assigned duties in a cooperative manner and perform all other related duties as assigned.
Be flexible in schedule of hours worked
Accept assigned duties in a cooperative manner and perform all other related duties as assigned
May require use of personal vehicle.

Knowledge, Skills and Abilities

Proficient knowledge of computer skills, including Microsoft Office (Word, PowerPoint, and Outlook)
Knowledge of general office procedures, equipment, and filing systems
Ability to communicate effectively, both orally and in writing
Ability to quickly learn department policies, procedures, goals, and services
Attention to detail and accuracy
Ability to change priorities regularly
Ability to think critically, take initiatives, and work independently with minimal supervision
Highly organized and ability to retrieve information quickly

Working Conditions and Physical Demands
The working conditions and physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Ability to access all areas of the center throughout the workday.
Ability to lift up to 35 pounds occasionally, 15 pounds frequently, and 7 pounds constantly; required to obtain assistance of another qualified employee when attempting to lift or transfer objects over 25 pounds.
Requires constant hand grasp and finger dexterity; frequent sitting, standing, walking and repetitive leg and arm movements, occasional bending, reaching forward and overhead; squatting and kneeling.
Work is generally performed in an indoor, well-lighted, well-ventilated, heated, and air-conditioned environment.

Experience

Minimum of two (2) years of professional experience in managed care organizations, required without an Associate’s Degree
Experience in the health care field, preferred.
Bilingual Spanish is required.

Education and Certification

Associate’s Degree, required without professional experience
Is medically cleared for communicable diseases and has all immunizations up-to-date before engaging in direct participant contact

Core Values

CARE is central to what we do, prioritizing the well-being, dignity, and independence of our senior participants.
COMPASSION in every interaction, ensuring kindness, empathy, and understanding guide our care.
CULTURE that reflects the diverse backgrounds of those we serve and fosters a workplace where every team member feels supported, valued, and empowered to grow.
COMMUNITY that fosters connection, belonging, and support for participants and their families.
COMMITMENT to quality improvement, innovation, and delivering healthier outcomes.

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

Apply Now

Refine Your Search

eligibility specialist jobs in fresno county ca

Eligibility Specialist

Client Relations Specialist

Payroll Specialist

Regulatory Compliance Specialist

Underwriting Specialist OR Executive Underwriter - Large Contract Surety

Enrollment Specialist

Admission Specialist

Bilingual Community Engagement Specialist (Remote, Full Time - Weekends)

Specialist: Seasonal, Part-time

Billing Specialist

HEALTH SERVICES SPECIALIST (SAFETY)

Historic Preservation Specialist

Compliance Specialist

Member Specialist

Information Technology Specialist

Billing System Specialist

Family Services Specialist

Experienced Energy Savings Assistance Program Specialist

Human Resource Expert

Floating Compliance Specialist

I want to receive the latest job alert for eligibility specialist in fresno county ca

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