Job description

Job Summary

The Engagement Specialist is responsible for a variety of duties, including enrollment, eligibility, and patient engagement. This position will help guide patients through the insurance process and assist in problem solving for various payers including insurance, HMO, Medicaid, Medicare and private pay.

Essential Duties and Responsibilities

· Work the eligibility queue and verified accuracy of billing data

· Assist insured patients with changes to their plans including PCP change forms

· Educate clients about Medicaid, Medicare, and other financial assistance programs, and assist with responding to questions and inquiries

· Assist in answering incoming calls transferred from Patient Service Center or outside providers

· Interact with staff, patients and agencies to answer questions, obtain information and resolve issues

· Participate in insurance campaigns to include patients at transitions in life such as aging into Medicaid, aging off parent’s coverage, patients eligible for low-income subsidies, etc.

· Work with the Managed Care Coordinator to assist with patients on gap list

· Assist and provide resources for patients with additional services available, such as CDSMP, cooking classes, and Health Education Classes

· Familiar with using electronic health record (Ex. Athena and NextGen)

· Other duties as assigned

Supervisory Responsibilities

This position has no direct reports.

Qualifications

· One (1) year of customer service experience (preferred)

Skills

Must have excellent communication skills. Ability to work independently and as part of a team; to receive and respond well to feedback. Possess strong interpersonal and problem-solving skills; time-management and organizational skills, including being punctual, responsive, and efficient. Perform job with professionalism and good judgment.

Work Environment and Physical Demands

With multiple locations and settings, PCHS’ work environment and physical demands vary greatly depending on the employee’s role. Essential job functions include the following: The employee is required to talk, hear, see, smell, sit and stand. The employee is frequently required to move around the facility; reach with hands and arms; climb or balance and stoop, kneel, crouch, or crawl. The employee is frequently required to lift and/or move up to 10 pounds and occasionally required to lift and/or move up to 25 pounds. Employees may be exposed to mechanical parts and moderate noise levels. Reasonable accommodations may be available to individuals with disabilities to perform their essential job functions.

Equal Opportunity

Peninsula Community Health Services is an equal opportunity/Affirmative Action employer and does not exclude persons from employment or application for employment from receipt of or participation in programs, activities, services on the grounds of race, color, sex, national origin, age, military status, marital status, religion, the presence of a physical, mental, or sensory disability, sexual orientation, gender identity, genetic information, victim of domestic violence, sexual assault or stalking, or any other characteristic protected by federal, state or local law.

Job Type: Full-time

Benefits:

• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Retirement plan
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Work Location: One location

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