Healthcare Eligibility Clerk

The Healthcare Eligibility Clerk/Financial Screening Clerk will be responsible for all patients requiring continuous program eligibility review. Will process all new patients and re-evaluate all existing patients for accurate application of eligibility on payer sources. The Financial Screening Clerk will need to have knowledge of all funding sources directly involving criteria, eligibility, and aid categories. In addition, the Financial Screening Clerk will maintain payer source records and opening of all family registration.

Tiburcio Vasquez Health Center is a non-profit community health center that is dedicated to promoting the health and well-being of our community by providing accessible, high-quality care by integrating primary care, dental care, WIC support, mental health counseling, community health education, and more.

This is a full-time position working 40 hours per week, typically Monday through Friday with periodic Saturday hours.

Compensation: $21.92 - $23.95 per hour, depending on experience.

TVHC offers compensation ranges that are determined by a thorough market-based analysis and are fully disclosed in accordance with California law. The pay for a selected candidate is determined by a variety of factors to ensure fair and equitable compensation. These factors include the candidate's experience, education, skills, training, licensure, certifications, and the specific scope of the role. We are committed to providing a competitive compensation package that extends beyond base salary, designed to support the health, wealth, and career development of our employees.

Responsibilities:

• Performs day-to-day administrative functions and general office duties including but not limited to word processing, copying, filing, faxing, answering phones, and data entry.
• Interviews all new patients who wish to register for medical services and greets them with respect and dignity. Determines eligibility for services and method of payment (e.g., MediCal, Medicare, Sliding Fee Scale, Family Planning Eligibility, Presumptive Eligibility, etc.)
• Adheres to all Clinic policies on safety and security; maintains restricted areas safe by safeguarding keyless entry codes and computer system passwords in strict confidentiality.
• Must exercise utmost diplomacy and tact to provide excellent customer service for patients; practices confidentiality and privacy protocols in accordance with Clinic policies and HIPAA requirements.
• Completes patient registration forms, verifies address and financial income information, and creates patient registration and account files through data entry onto the health center's computer system.
• Starts new patient medical records with all required forms, assigns and maintains a log of medical records numbers that have been dispensed.
• Creates a clinic card for each new patient and updates existing cards for established patients as may be required.
• Explains the services available, charging and billing policies, and patient rights and obligations to the health center.
• Counsels patients about the availability and utilization of community and county agencies for financial assistance and make referrals as appropriate.
• Provides ongoing eligibility review for established patients as stated by the health center policies and upon request from the reception supervisor and clerks.
• Corresponds by mail or telephone with patients to obtain required information to verify financial status or address.
• Assures compliance with all funding sources including state, city, county, and federal regulations.
• Treats all patients with respect and courtesy; respects the patient’s rights to confidentiality and works cooperatively with other members of the professional and non-professional staff.
• Works in tandem with the Financial Eligibility Coordinator and Registration Services Coordinator to ensure proper computation of information for billing and management reports. Coordinates in conjunction with Financial Eligibility Coordinator in data input of new registrations and retrieval of established patients.
• Exercises problem-solving and conflict resolution skills when handling patient complaints; refers patient complaints to appropriate designated personnel as needed.
• Will travel among sites and work flexible hours, as required.
• Performs all duties and services in full compliance with TVHC’s Service Excellence Standards.
• Performs all duties in support of successful EHR/EPM implementation.
• Performs other services as may be required. May rotate as needed to different clinic sites.

Requirements

• High school graduate or GED required.
• Bilingual in English and Spanish required.
• Minimum one-year experience in third-party billing, state-funded programs, payor source, and billing procedures required.
• Minimum two full years of clerical responsibility involving a broad range of duties; such duties may include: a. processing of documents related to financial or personal histories; b. interviewing; c. general clerical work.

Qualifications:

• Understands the importance of maintaining confidentiality; able to maintain confidentiality under HIPAA standards.
• Must have the ability to exercise a high degree of diplomacy and tact; excellent customer service and interpersonal communication skills; Cultural sensitivity and demonstrated ability to work with diverse people groups.
• Ability to work well under pressure with minimal supervision. Proven flexibility and willingness to handle a variety of tasks. Knowledge of basic math and modern office procedures.
• Excellent attention to detail.
• Computer knowledge, e-mail, and internet skills necessary.
• Willingness to learn new data systems.
• Willingness to work evenings and/or weekends.

Benefits

We offer excellent benefits including: medical (100% paid co-payments, premiums, etc.), dental, vision (including dependent and domestic partner coverage), generous paid leave benefits including holidays, Flexible Spending Accounts, retirement plans with an Employer match, tuition reimbursement, monthly treats, pet insurance, and more.