Eligibility Specialist

About Seen Health

At Seen Health, we are revolutionizing the way senior care is delivered through the PACE (Programs of All-Inclusive Care for the Elderly) model. Backed by top VCs, Seen Health is a culturally-focused, technology-enabled healthcare organization that integrates comprehensive medical care and social support with a high-touch, interdisciplinary approach.

Our mission is to empower seniors to age-in-place with dignity and provide their families peace of mind. We are building upon a proven Home and community based services model to create a culturally-competent and scalable PACE program. We are also building a comprehensive operating system focused on data and workflows that span across systems, processes, people, and care contexts. We want to empower our clinicians and staff with tools that deliver relevant data at the time and site of care and enable them to deliver exceptional care to our participants, which improve clinical outcomes, participant & provider satisfaction, and ultimately our strength as an organization.

We are a mission-driven, multidisciplinary team with deep healthcare, technology, and operations expertise, each inspired by our own personal stories of caring for seniors in our lives. Our name, Seen Health, was chosen to reflect our commitment to provide the highest standard of care to underserved older adults while respecting and incorporating their individual beliefs, heritage, and values, so that they can truly be seen.

About The Role

The Eligibility Specialist is responsible for conducting eligibility screenings, assessment of patient financial requirements, and enrollment in Medi-Cal. The Eligibility Specialist is a liaison between Seen Health participants and governmental agencies, and is actively involved in all case management areas.

Location: Alhambra, CA

Status: Full-time

Schedule: Monday-Friday, 7:30 a.m. to 4:30 p.m. or 8:00 a.m. to 5:00 p.m.

Mileage and Expense Reimbursement

Responsibilities

• Conduct eligibility screenings, assess patient financial requirements, and assist with enrollment where applicable
• Screen and evaluate patients for existing insurance coverage, federal and state assistance programs
• Re-verifies benefits and obtains authorization and/or referral after treatment plan has been discussed, prior to initiation of treatment
• Ensures appropriate signatures are obtained on all necessary forms
• Obtain legally relevant medical evidence, physician statements and all other documentation required for eligibility determination
• Complete and file applications
• Initiate and maintain proper follow-up with the patient and government agency caseworkers to ensure timely processing and completion of all mandated applications and accompanying documentation
• Ensure all insurance, demographic and eligibility information is obtained and entered into the system accurately
• Document progress notes to the patient's file
• Participates in ongoing, comprehensive training programs as required
• Follows policies and procedures to contribute to the efficiency of the office
• Covers and assists with other office functions as requested
• Will be required to make field visits as necessary and will need reliable personal transportation readily available
  
  

Qualifications

• High School graduate or equivalent required.
• Minimum of two (2) years of work experience in a customer-facing administrative role (i.e. walk-in customer service, reception).
• Minimum one (1) year experience working with the frail or elderly in a volunteer or professional capacity.
• Experience and excitement to work with a diverse population of colleagues and participants.
• Excellent interpersonal skills, including ability to communicate in a professional and warm manner and provide clear and accurate verbal and written communications.
• Thrive in a busy, engaging environment with multiple interruptions and varied types of work.
• Highly organized, able to prioritize tasks and conduct thorough follow-up.
• Computer proficient with experience in Microsoft Office Suite, scheduling systems, and other relevant office technology.
• Familiarity and moderate technical understanding of office equipment; ability to troubleshoot and report issues to servicers, as needed.
• Experience working with dementia population, preferred.
• Experience with electronic health record system preferred.
• Experience working within the framework of an interdisciplinary team preferred.
• Bilingual: Mandarin/English or Cantonese/English Preferred.
  
  

Salary and Benefits

• Pay Rate: $20-$30/hr
• Equity: included as part of founding team package
• Benefits: Seen Health is proud to offer a robust benefits offering for our employees. In addition to traditional healthcare coverage, we also offer additional benefits to help further your wellness and feeling of being part of the team.
• Medical, Dental, and Vision benefits for you and your family
• Life Insurance and Disability Benefits
• Parental and Caregiver Leave
• Lunch, as well as delicious snacks and coffee to keep you energized
• Paid Time Off across holidays, vacation time, personal days, and sick days
• 401k Plan
• Personal and professional development, including CME support and career growth opportunities
• Subscriptions and training on using AI tools including ChatGPT
  

Seen Health does not discriminate in employment opportunities or practices on the basis of race, color, religion, gender, gender identity, pregnancy, national origin, age, disability, creed, ancestry, genetic information, marital status, sexual orientation/identity, transgender status, military or veteran status, or any other characteristic protected by federal, state, or local law. This prohibition includes unlawful harassment based on any of these protected classifications.