Metro Wellness & Community Centers is looking for an Eligibility Specialist. Under general supervision of the Vice President of Health Center Services and in collaboration with the health center team, the Eligibility and Linkage Specialist determines patient eligibility for sliding fee discounts and for third party reimbursement, processes data necessary for admission of new patients into health services, and handle inquiries from prospective patients. This position is also responsible for the linkage of patients to other Metro services and community resources based on eligibility.

Primary Tasks/Responsibilities:

Essential functions are those tasks, duties, and responsibilities that comprise the means of accomplishing the job s purpose and objectives. Essential functions are critical or fundamental to the performance of the job. They are the major functions for which the person in the job is held accountable.

  • Conduct Health Center Discount program eligibility for clients following procedures and guidelines specific to each program.
  • Assess clients for other payer sources such as Medicaid, Medicare, ADAP, and any other third party insurance.
  • Confirms eligibility appointments with clients.
  • Register patients/clients into organization’s electronic medical record system (eClinicalWorks).
  • Maintains up-to-date and organized eligibility records.
  • Conducts renewal eligibility as required by each program to include sliding fee discount program.
  • Distribute training, technical assistance and general program information to patients / clients regarding Metro services and programs
  • Sets initial service appointments once eligibility has been determined.
  • Provides clients with list of required eligibility documentation.
  • Will combat any identified barriers to care (i.e. transportation, insurance status) by connecting the patient to supportive services to eliminate or ease these barriers to medical care.
  • Will facilitate direct and immediate linkage to on-site medical care at Metro Health Centers, as well as other wraparound supportive services onsite and within the community, promoting continuity and reducing barriers to care.
  • Participates in the Health Center’s Performance Quality Improvement Program.

Education/Professional:

  • Bachelor’s Degree in a social services field preferred.
  • Minimum of 1 year experience working in a health care setting, preferably performing similar activities.

Knowledge, Skills and Abilities Required:

  • Demonstrates respect and regard for the dignity of all patients, families, visitors and fellow employees to insure a professional, responsible and courteous environment.
  • Promotes effective working relations and works effectively as part of a team.
  • Knowledge of community resources in the Tampa Bay area.
  • Knowledge of the Affordable Care Act/market place plans enrollment process.
  • Understanding of the needs of medically underserved populations.
  • Ability to effectively communicate orally and in writing.
  • Ability to operate computers and other office machines required.
  • Medium proficiency with Microsoft Office programs and electronic medical records systems.
  • Must be able to work in a fast paced, flexible environment.

Requirements:

  • Must possess and maintain valid Florida driver’s license and proof of insurance
  • Must have reliable and accessible auto vehicle.
  • Must pass necessary fingerprinting, Level II background checks and employment eligibility verification through the U. S. Department of Homeland Security’s E-Verify system, https://e-verify.uscis.gov/emp.