Enrollment Specialist I (Los Angeles, CA)

About This Job

APLA Health is dedicated to advancing health equity and enhancing wellness within the LGBT community, individuals living with or impacted by HIV, and other underserved populations. As a nonprofit, federally qualified health center, we serve over 14,000 people each year across 15 locations in Los Angeles County. Our comprehensive range of more than 20 services includes medical, dental, and behavioral health care; PrEP counseling and management; health education and HIV prevention; and STD screening and treatment. For those living with HIV, we provide housing support, benefits counseling, home health care, and access to the Vance North Necessities of Life Program food pantries, along with other essential services. We also champion policy and legislative advocacy for the LGBT and HIV communities, offer capacity-building support to health departments nationwide, and engage in community-based research on issues affecting those we serve. For additional details, please visit us at aplahealth.org.

We provide excellent benefits, competitive compensation, and a positive workplace.

We offer:

• Medical Insurance
• Dental Insurance (no cost for employee)
• Vision Insurance (no cost for employee)
• Long Term Disability
• Group Term Life and AD&D Insurance
• Employee Assistance Program
• Flexible Spending Accounts
• 11 Paid Holidays
• 4 Personal Days
• 10 Vacation Days
• 12 Sick Days
• Metro reimbursement or free parking
• Employer Matched (6%) 403b Retirement Plan

This role presents a meaningful opportunity to create a positive impact.

The hourly wage for this position ranges from $25.60 to $28.82. Compensation is based on experience.

Please note: Spanish fluency is required for this role. An assessment will be administered prior to advancing in the hiring process.

POSITION SUMMARY:

Reporting to the Enrollment & Eligibility Manager and in compliance with HRSA contract stipulations, the Enrollment Specialist I aids clients directly or through referrals with enrollment and re-enrollment in Covered CA, Medi-Cal, Medicare, and MHLA, as well as with accessing Public Benefits.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Screen clients via PointCare for eligibility and assist with enrollment/re-enrollment in Covered CA, Medi-Cal, Medicare, MHLA, commercial plans, Ryan White, ADAP, and PrEP-AP, and with accessing Public Benefits.
• Act as the primary APLA Health & Wellness contact for resolving issues related to health plans within contracted independent physicians associations (IPAs), such as Health Care LA IPA and Regal Medical Group.
• Document interactions and maintain client files using Point Care to efficiently qualify and enroll patients into coverage.
• Remain informed about all APLA Health programs.
• Follow up to confirm enrollment application status and assist clients encountering problems.
• Complete a thorough benefits and qualified health insurance assessment for each client.
• Maintain and update all client records in the eClinicalWorks electronic health record system, ensuring data accuracy.
• Answer and respond to incoming calls and emails regarding eligibility for qualified health plans and Public Benefits per agency policy.
• Explain summary of benefits documents, their location, and how to find provider network information.
• Collaborate with other APLA Health & Wellness programs and external service organizations to facilitate service delivery.
• Maintain broad awareness of client resources, both within the agency and across the Federally Qualified Health Center (FQHC) network.
• Prepare required reports and client records to fulfill APLA Health & Wellness, city, state, and federal program requirements.
• Adhere to agency policies and standards regarding client confidentiality and HIPAA compliance.
• Communicate effectively with clients/patients in English and Spanish as required by job duties.

Other duties may be assigned as needed to meet business requirements.

REQUIREMENTS:

Training and Experience:

A high school diploma and one year of experience in benefits enrollment. Must be certified as a Medi-Cal Enroller, Covered CA Certified Enrollment Counselor (CEC), and ADAP/OA HIPP/PrEP-AP Enroller, or obtain these certifications within six months of hire. Strong writing, proofreading, grammar, and interpersonal customer service skills are essential. Bilingual Spanish/English proficiency is required.

Knowledge of:

Interviewing and assessment techniques; vocational rehabilitation or related fields; word processing and eClinicalWorks electronic health records data entry; HIV and related chronic illness and disability issues; comprehensive understanding of public benefits programs and policies; qualified health plans, including Covered CA, Medi-Cal, Medicare, My Health LA, and Ryan White. Must possess knowledge of the healthcare field.

Ability to:

Work with minimal supervision; assess psychosocial and occupational/vocational needs; utilize agency and community resources; communicate effectively both verbally and in writing in one-on-one and public settings; respond empathetically to the needs of clients, staff, and volunteers; function as a team member in a diverse, multicultural environment. Bilingual English/Spanish is required.

WORKING CONDITIONS/PHYSICAL REQUIREMENTS:

Work with minimal supervision; assess psychosocial and occupational/vocational needs; utilize agency and community resources; communicate effectively both verbally and in writing in one-on-one and public settings; respond empathetically to the needs of clients, staff, and volunteers; function as a team member in a diverse, multicultural environment.

SPECIAL REQUIREMENTS:

Must possess a valid California driver’s license, proof of auto liability insurance, and have access to a personal vehicle for work-related purposes. COVID-19 vaccination and booster, or a Medical/Religious exemption, is required.

We are an Equal Opportunity Employer: minority/female/disability/transgender/veteran.

To Apply:

Visit our website at www.aplahealth.org to apply or use the following link:

https://www.paycomonline.net/v4/ats/web.php/jobs/ViewJobDetails?job=296425&clientkey=A5559163F67395E0A2585D2135F98806