Loma Linda University Health

Job Summary: The Medi-Cal Eligibility Specialist assesses, advises, informs, and assists the uninsured and the underinsured patients in determining eligibility and liability for Inpatient, Outpatient, Emergency Room, Observation admission and services.. Interviews patients or their families to establish Hospital Presumptive Eligibility, Medi-Cal Fee for Service, SOC, Cash payment and/or Charity linkage in accordance with all federal, state and local laws, rules and regulations that apply to activities pursuant to these program.. Patient liaison between outside County Eligibility worker and patient.. Able to read, write legibly; speak in English with professional quality; use computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint, Availity, Medi-Cal, HPE, LLEAP).. Loma Linda University Health is a Seventh-day Adventist, faith and values based Christian institution.

Eligibility

Job Description Job Summary: The Medi-Cal Eligibility Specialist assesses, advises, informs, and assists the uninsured and the underinsured patients in determining eligibility and liability for Inpatient, Outpatient, Emergency Room, Observation admission and services. Interviews patients or their families to establish Hospital Presumptive Eligibility, Medi-Cal Fee for Service, SOC, Cash payment and/or Charity linkage in accordance with all federal, state and local laws, rules and regulations that apply to activities pursuant to these program. Initiates and follows Medi-Cal and other County, State or Federal applications to completion for approval or denial. Determines and collects patient liability for all urgent and emergent, international and cash admissions. Assists patients with appeal processes when applications are denied. Patient liaison between outside County Eligibility worker and patient. Performs other duties as assigned. Education and Experience: High School Diploma or GED required. Minimum three years of experience required in hospital-based registration, Medi-Cal, Customer Service and California Children's Services required with emphasis on Federal, State, and County eligibility regulations and requirements preferred, five years preferred. Knowledge and Skills: Able to keyboard 35 wpm. Able to read, write legibly; speak in English with professional quality; use computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint, Availity, Medi-Cal, HPE, LLEAP). Operate/troubleshoot basic office equipment required for the position. Able to relate and communicate positively, effectively, and professionally with others; work calmly and respond courteously when under pressure; collaborate and accept direction. Able to communicate effectively in English in person, in writing, and on the telephone; think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Able to distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone, and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position. Licensures and Certifications: Valid Driver's License required at time of hire. Certification from the Department of Social Services in Medi-Cal eligibility determination preferred. About Us Our mission is to continue the teaching and healing ministry of Jesus Christ. Our core values are compassion, excellence, humility, integrity, justice, teamwork and wholeness. About the Team Loma Linda University Health is a Seventh-day Adventist, faith and values based Christian institution. Candidates must understand and embrace the mission, purpose, and identity of Loma Linda and its affiliated entities. We are an equal opportunity employer committed to the principles of diversity. We provide equal opportunities in all aspects of the employment process to every individual, regardless of gender, race, color, age, national origin, ancestry, physical or mental disability, marital or veteran status, genetic information or any other characteristic protected by law. In addition, we will provide reasonable accommodations for otherwise qualified individuals requesting an accommodation due to a disability. If you need accommodation assistance with accessing our job listings or completing an application, or during any other phase of employment with us, please contact Human Resources Management at (909) 651-4001. Loma Linda University Shared Services is a religiously-qualified Equal Opportunity Employer under Title VII of Civil Rights Act of 1964. No question on this application is asked for the purpose of unlawfully limiting or excluding any applicant's consideration for employment because of race, color, religion, gender, age, national origin, disability, genetic information, or any other status protected by applicable law. If you need a reasonable accommodation in the hiring process, please notify Human Resource Management. We appreciate your interest in Loma Linda and wish you success in your job search!

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