West Hawaii Community Health Center

WEST HAWAII COMMUNITY HEALTH CENTER POSITION DESCRIPTION

JOB TITLE: ELIGIBILITY SPECIALIST FLSA Non-Exempt STATUS: DEPARTMENT: Front Desk SUPERVISED Front Desk Manager BY:

I. POSITION FUNCTION SUMMARY: Under the general direction of the Front Desk Manager, the Eligibility Specialist is responsible for conducting eligibility screenings, assessment of patient financial requirements, and counseling patients on insurance benefits and co-payments. ESSENTIAL DUTIES AND RESPONSIBILITIES This position may have various work assignments within WHCHC. This description is intended to be generic in nature, and as such it does not detail all of the duties and responsibilities of a particular job assignment. It is not intended to determine specific duties and responsibilities of any particular position, and essential functions and overtime eligibility may vary based on the specific tasks assigned to the position: Essential Job Functions: 1. Screen and evaluate patients for existing insurance coverage, and federal and state assistance programs 2. Contact insurance company to verify patients’ coverage and benefits, checking for coverage of specific services, such as physicals, etc. 3. Initiate and maintain proper follow-up with the patient concerning coverage and benefits 4. Ensure all insurance, demographic and eligibility information is obtained and entered into the system accurately. Review non covered benefits with patients and discuss payment options such as SFS (Sliding Fee Scale), payment plans, etc. 5. Participates in ongoing, comprehensive training programs as required. 6. Follows policies and procedures to contribute to the efficiency of the office. Covers and assists with other office functions as requested. All other duties as assigned

II. POSITION QUALIFICATIONS Requirements of Positions To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education and Experience High School graduate or GED certificate and six months to one year related experience and/or training is required; OR any equivalent combination of experience, training and/or education. Knowledge, Skills and Abilities Position requires basic knowledge of general office procedures including filing, copying, faxing.  Ability to use a computer to enter patient data and retrieve information to generate reports.  Ability to work on multiple tasks within established deadlines.  Ability to work under the direction of a supervisor and follow instructions.  Ability to take the initiative to resolve patient concerns and problems. Language Skills:  Ability to read and interpret documents such as government regulations and guidelines, patient records, operating and maintenance instructions, procedure manuals, etc.  Ability to write at a minimal level of competence, including internal reports and memoranda.  Ability to communicate with diverse groups of people to include staff and providers and patients.  Ability to communicate effectively with patients and their families to make their visit a pleasant experience.  Sensitivity to the multicultural nature of the service area population and may be required to communicate in another language. Personal Characteristics Personal characteristics to include: a team player, high integrity, communication and customer relations skills, regular work attendance, courteous and friendly, able to work well with diverse groups of people, and gain and maintain respect of others. Confidential and Sensitive Information: Because the employee has access to personal and professional data regarding individual employees and their families, personal data regarding individual patients and the families, and/or sensitive company financial data, an essential job result is the maintenance of a high level of confidentiality of the information processed by the employee. Violation of this confidence may result in disciplinary action, including termination of employment.

III. PHYSICAL CHARACTERISTICS/WORKING CONDITIONS General Remarks: The work environment described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential tasks and functions. Environment: The noise level in the work environment is usually moderate. There are no known environmental hazards on the premises. Work environment is often stressful. Work is mostly inside, and normal office worker safety precautions and practices are required. Incumbent may be exposed to patients' conditions and some-unpleasant sights, smells and contagious diseases including virus, disease and infection from patients and specimens in working environment. All employees are offered the opportunity to receive the Hepatitis B vaccination series. Equipment Use: Frequent use of telephone system and office equipment including but not limited to computer, printer, facsimile machine, copier and general office supplies. Occasional use of wheelchair, gurney and other assisted devices for patient transfers in the clinic. Work Hours: Eight hour work days. Overtime may be required. Mental Demands: Duties require attention to detail, alertness, problem solving, tolerance to stress and exercising sound judgment. Duties require high tolerance and adequate coping skills for dealing with loss, grief and bereavement. Good stress reduction and management skills are essential.

IV. REMARKS: The foregoing position description is not all-inclusive of the duties that may be assigned to the employee. In order to ensure maximum flexibility and efficiency and to encourage cross training, employees will be assigned additional duties as deemed necessary or desirable by WHCHC. I have read my Position Description and understand my assigned responsibilities, and have been given a copy of this Position Description. I also understand that the Board of Directors and management of the West Hawaii Community Health Center cannot guarantee my employment, and that WHCHC can change compensation, benefits, and conditions of my employment at any time and at its full and sole discretion. I also certify by my signature below that I am able to perform the essential functions of this position description without a reasonable accommodation. Accepted by: Employee Date Approved by: Human Resources Date