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Access Specialist - Enrollment

Cleveland, OH, USA Req #539
Tuesday, November 19, 2019

JOB SUMMARY


The Access Specialist serves as a point of contact for potential and current clients, Centers staff and external providers to facilitate access to coordinated care. The Access Specialist responds to treatment service requests; schedules appointments; makes referrals to other community resources; and actively promotes The Centers services.

JOB QUALIFICATIONS

Core Competencies

 * Customer Service Acumen

 * Communicator: Listening, Connecting

 * Cultural Diversity

 * Planning & Organizing

 

Education

 * Must have a high school diploma or equivalent;

 * May be Bilingual in English and Spanish.

 

Specific Knowledge (upon hire or acquired within the first six months of employment)

 * Must understand entitlements, including Medicaid and Medicare eligibility requirements and various insurance plans.

 * Knowledgeable about behavioral health service delivery and the community behavioral health system preferred.

 * Prioritize multiple activities and maintain positive relations with a wide variety of people.

 * Must be able to multitask in a fast-paced environment.

JOB DUTIES & RESPONSIBILITIES

 * Operates and promptly answers Health & Wellness (HW) Enrollment phone lines to ensure accessibility to callers; includes timely response to voice mail messages and effective call management.

 * Completes enrollment process for HW and AOD services and completes EMR entry.

 * Determines a match for additional services based on client needs and The Centers’ available services; makes external referrals as appropriate.

 * Obtains site census data from site leadership to accurately promote program availability.

 * Participates in marketing and promotion of Centers services including distribution of marketing materials, through mailing materials and in person discussions with interested referral sites.

 * Liaisons with external referral sources; provides information as needed

 * Work with Centers Entitlement and Billing departments which includes:

  • Understands and interprets insurance coverage and determines which services can be provided to a client; Information is shared with potential clients, and internal Entitlement and Billing departments

  • Performs insurance eligibility and verification processes for new clients to help ensure that accurate claims are submitted by the Billing department, to payors.

  • Initiates process, prescribed by the Billing department for uninsured clients so that services can be provided and reimbursed through charitable funds.

  • Initiates referrals to internal Entitlement department to help clients receive benefits for which they are eligible.

*Completes “Rapid Access” enrollment process and “discharge coordination” with hospitals which includes:

  • Completes client enrollment in EMR

  • Maintains provider schedule in EMR and Outlook schedules

  • Obtains client follow up appointments from internal psychiatric providers and communicates   appointments to hospitals and case managers.

  • Maintains data base to track Rapid Access outcome data, and client/hospital follow up data to ensure client needs are met

  • Appropriately distributes hospital records to Centers providers

  • Liaison for hospital social workers and referral systems to provide information, problem solve and follow up on any issue related to rapid access.

 * Maintains hospital based sites on-going schedule which includes:

  • Completes client enrollment in EMR

  • Maintains provider schedule in EMR and partner hospital EMR

  • Responds to partner hospital “client hot lines” to answer questions and change appointments.

  • Liaison for hospital based staff and referral sources to provide information, problem solve and to follow up on any issue related to enrolling a client

Other Job Duties

 * Performs other related duties as assigned.

Work is performed primarily in an office environment. Involves, sitting and standing throughout the day in a shared office environment which may include distractions. Involves speaking frequently by telephone.

This job description is not intended to be a complete list of all responsibilities, duties or skills required for the job and is subject to review and change at any time, with or without notice, in accordance with the needs of The Centers. Since no position description can detail all the duties and responsibilities that may be required from time to time in the performance of a job, duties and responsibilities that may be inherent in a job, reasonably required for its performance, or required due to the changing nature of the job shall also be considered part of the jobholder's responsibility.

Other details

  • Pay Type Hourly
  • Cleveland, OH, USA