Guide

MISSION : To inspire health, wellbeing and humanity in our community, through all of life’s stages.

Is this the role you are looking for If so read on for more details, and make sure to apply today.

JOB SUMMARY : The Bilingual Health Coverage Guide will conduct financial screening and gather patient documentation to determine qualification for payment programs.

This position will register patients into billing systems, including status change updates. The role performs eligibility screenings including paperwork and follow-up, and insurance verification.

This position also facilitates enrollment for affordable health insurance coverage through the Health Insurance Marketplaces, Children’s Health Insurance Program (CHP ) and Health First Colorado (Medicaid).

The Bilingual Health Coverage Guide provides patients with education and information regarding Tepeyac’s Policies and Procedures, access to care, and integrated services offered at Tepeyac.

ESSENTIAL DUTIES & RESPONSIBILITIES :

• Maintain knowledge of eligibility and enrollment procedures for health insurance programs including Health First Colorado, CHP , CICP, Clinic Sliding fee discount, health insurance through Connect for Health Colorado, Ryan White, WWC and / or other programs and services at Tepeyac.
• Screen and enroll patients in the appropriate medical assistance programs for which they qualify.
• Utilize PEAK and Connect for Health Colorado websites to enroll patients in the appropriate programs.
• During Open Enrollment, outreach to eligible individuals and assist those individuals in applying for health Insurance, provide impartial assistance in understanding health insurance and in plan selection.
• Counsel all patients on the programs for which they qualify including the possibility of Special Enrollment Periods (SEP) for changes due to loss of Minimum Essential Coverage, change in legal presence, among other life changing events.
• Verify Health First Colorado Eligibility through the Colorado State provider portal and outreach to newly ineligible patients to discuss healthcare insurance / benefit options.
• Stay up to date on all policy updates for state and federal medical assistance programs.
• Outreach to all new obstetrics patients within 30 days of pregnancy confirmation to ensure they are enrolled in appropriate program including Prenatal State Medicaid, Prenatal State CHP or Emergency Medicaid programs as well as the Sliding Fee Discount program (if appropriate) and ensure that eligible women are referred to St.

Joseph Financial Counselors.

• Ensure newborns are enrolled in Medicaid or CHP within 30 days of birth by submitting forms to appropriate counties and complete follow up to ensure that enrollment in the programs is completed.
• Maintain communication with partner organizations (like St. Joseph Hospital) to ensure that patients’ needs are met, and they are enrolled in the appropriate programs.

Biannually reevaluate all Ryan White patients for continuous eligibility and coordinate with the case management team to streamline outreach.

• Maintain accurate documentation in the EHR about the status of financial assistance for each enrollment appointment completed and any further action needed.
• Attend all required program meetings, trainings, and conferences.
• Follow policies and procedures as set forth by the Colorado Department of Health Care Policy and Financing and the Colorado Department of Public Health and Environment to determine program eligibility and enrollment practices.
• Serve as the subject matter expert for all enrollment related questions.
• Follow up on all provider referrals for patient enrollment eligibility.
• Serve as a resource for patients regarding account balances.
• Educate patients on insurance and how its billed and what their responsibilities are.

OTHER DUTIES AND RESPONSIBILITIES :

• Greet everyone in a welcoming manner.
• Coordinate with all departments to ensure patient satisfaction.
• Identify patients’ needs, clarify information, research every issue and / or request and provide solutions and / or alternatives.
• Inform patients of required documents and / or information needed for appointment.
• Register patients into the EHR completely and accurately.
• Follow all protocols and procedures pertaining to patient confidentiality.
• Check voice messages and return calls within Tepeyac expected time frames.
• Follow procedures for the EHR system and adhere to all confidentiality policies and procedures.
• Assist with Front Desk Duties on Saturdays.
• Attend required internal meetings, trainings, and events.
• Other duties as assigned.

EDUCATION AND EXPERIENCE :

Minimum Education :

High School diploma or GED required.

Minimum Experience :

• Three years’ experience in healthcare required including one year of enrollment experience; financial counseling, billing, eligibility determination, FQHC experience preferred.
• Experience working with people in one-on-one, group settings, and the community.

KNOWLEDGE, SKILLS & ABILITIES :

• Oral and written fluency in English and oral fluency in Spanish required.

Critical thinking skills to provide the best outcome for each patient.

• Basic knowledge of health insurance and health service delivery.
• Knowledge of program rules for Health First Colorado (Medicaid), Child Health Plan Plus (CHP ), Colorado Indigent Care Program (CICP), and Connect for Health / Marketplace.
• Ability to understand, keep up with updates and changes with all program regulations, policies and procedures.
• Highly proficient computer skills including MS Word, Excel, and Outlook.
• Excellent oral and written communication skills to include presenting and speaking in public settings.
• Higher level math skills, self-motivated and able to achieve results through good organizational skills, ability to work independently, self-directed and a functional team member, ability to organize and prioritize.

Ability to explain and summarize detailed concepts such as Medicaid / CHP Enrollment Process, program benefits, policies, and procedures that the general population can understand.

• Sensitivity to low income and ethnic minority communities.
• Ability to multitask, prioritize work and meet deadlines.
• An ideal candidate should have a strong initiative and the passion to advocate and provide healthcare to the underserved.

Schedule : This position will work Monday-Friday, 8 : 00am - 5 : 00pm with an hour for lunch and Saturdays (as needed) 8 : 00am - 12 : 00pm.

PAY & BENEFITS :

Benefits : Tepeyac offers a full compensation package to all full-time employees. Benefits include medical, dental and vision insurance, a flexible spending account, a 401k, disability insurance paid for by Tepeyac, eight paid holidays, four weeks of vacation and 6 days of sick leave each year.

The hourly range for the Bilingual Health Coverage Guide position is $24.21 / hour .

Apply : If you are interested in applying, send your cover letter and resume to hr@tepeyachealth.org - We look forward to hearing from you!

Vaccinations : As required by Colorado’s CMS Vaccine Mandate, all Tepeyac Community Health Center employees must be fully vaccinated against COVID-19, subject to the requirements of the American with Disabilities Act (42 U.

S.C. 12101 et seq..), Title VII of the Civil Rights Act (42 U.S.C. 2000e et seq.), the Colorado Anti-Discrimination Act (C.

R.S. 24-34-401 et seq.), and any other relevant federal or State law. As such all persons offered a position will be required to provide valid proof of vaccination prior to starting employment.

Last updated : 2024-09-08

Salary : $24