The Patient Retention in Care Specialist is responsible for working as the internal liaison in maintaining, processing and reviewing the department databases and reporting on a daily basis to assist the Managed Care Department in meeting the overall patient population growth and assist the Managed Care Administrator in developing goals and strategies to outreach, and retain patients. The Patient Retention in Care Specialist will also be responsible for conducting outreach and in-reach to individuals and community organizations, including schools, about health care and availability of SCFHC services and programs.
Retention in Care 80%
- Educates patients about health insurance enrollment process and programs.
- Responsible for making reminder calls to patients that are due for re-credential/re-enrollment
- Responsible for timely and accurate completion of enrollment forms for private, Commercial Insurance, Medicare, and Medi-Cal, as well as other County or State health insurance programs.
- Completes production reports, Medi-Cal reports, Medicare Reports, Commercial Insurance Reports, Communication Sheets, PCP changes and tracking, and all other applicable reports.
- Handles Medi-Cal, My Health LA, Medicare, Covered California, and other renewals on an annual basis to retain coverage.
- Handles patients who do not qualify with care and empathy.
- Keeps up with changes in programs as appropriate.
- Utilize Electronic Health Records to process registration, scheduling and billing.
- Processes applications and verifies eligibility during the patient visit.
- Works with clinicians to identify and qualify patients for financial assistance programs.
- Maintain patient confidentiality so that HIPPAA compliance is observed at all times.
- Conducts outreach to schools in SCFHC service area. Establish and maintain relationships with school community liaison and nursing/health staff
- Conducts outreach and education to parents and students through PTA meetings, ESL, and other groups.
- Identifies opportunities and coordinate participation of SCFHC outreach staff in community health fairs
- Conduct health education presentations to community organizations in SCFHC service are, such as churches, recreation centers, and other agencies
- Builds partnerships between SCFHC and health and human services agencies and collaborative in the SCFHC services area/ SPA 6 regions to promote clinic services and promote exchange of information & resources
- Assists in the collection of patient satisfaction surveys
- Attends training sessions on health policy & advocacy issues.
- Research health policy and advocacy issues and rely pertinent information to SCFHC staff and patients
- Identifies and develop initiatives to promote patient satisfaction and advocacy efforts
- Assists in development of tracking and evaluation system to assess the impact of the outreach staff on patient referrals to the clinic
Education and Knowledge
· Certified Application Assistant (CAA Certificate) required
· BA Degree preferred in health education, public health, or related field
· Demonstrate knowledge of safety, infection control & emergency policies and procedure
Knowledge of Los Angeles County health care system and community-based organizations
· Must have minimum 2 – 3 years’ experience in community-level health education or related field
· Must be able to work independently within scope of assigned task with minimum supervision
· Familiar with Covered CA, Medi-Cal, Medi-Cal for Families and My Health LA
· EHR- Electronic Health Record (Required)
· Must be able to cope in a “fast pace” environment.
Licensure and Certifications