Job Description

Job Description

Job Description

JOB DESCRIPTION

Position: Eligibility Screener

Reports to: Vice-President of Support Operations

Revised: July 18, 2025

Department: Clinical Service

FLSA: Non-Exempt

Job Purpose:

The Eligibility Screener is responsible for conducting verification screening and documentation collection for all clinic patients accessing services, including verifying eligibility for sliding fee discount program, Ryan White funded programs, Affordable Care Act (ACA), and Medicaid or Medicare.

Essential Job Functions including, but not limited to:

1. Satisfies Core Competencies

· Accepts responsibility for ensuring that performance meets the standards of the departmental requirements and OHCC core values.

2. Customer Service

· Maintains effective communication between inter-agency providers to coordinate services.

· Maintains current awareness of community resources and public benefits available to clients.

· Handles confidential and sensitive client/patient information using HIPPA guidelines.

· Participates in performance improvement activities and initiatives on-going.

· Delivers culturally and linguistically competent customer service consistently.

3. Eligibility

· Screens patients for Medicaid, Medicare, ACA, and Sliding Fee Discount Program (SFDP) eligibility.

· Enrollment in Marketplace insurance.

· Completes SFDP applications for uninsured/underinsured patients annually

· Completes Medicaid applications for visitors and patients

· Conducts initial and annual eligibility screenings for new and existing Ryan White patients seen at OHCC.

· Pre-registration for all locations and providers. Includes call confirmations

· Portal registration

· Completes Louisiana Health Access Program (LAHAP) applications for clinic patients.

· Effectively coordinates and communicates with other staff regarding the status of eligibility for and access to services. Completes applicable forms and attaches to electronic record

· Completes required documentation in a timely manner.

· Maintains awareness of grant programs available to clinic patients.

· Verifies benefits for commercial and Medicare insurance plans prior to appointments

· Maintains current awareness of medication assistance programs to collaborate with service providers in the provision of HIV medications.

· Facilitates the completion of required documents for grant programs for access to services.

· Educating patients on benefits

Required Education

- High School Diploma.

- Five (5) years’ experience in insurance or Ryan White may be substituted.

Skill, Licensure and Knowledge Requirements

- Proficiency in Windows, Microsoft Office, and typing skills are required.

- Excellent verbal, customer service, and written skills.

- Exceptional organizational skills.

- Bilingual Spanish/English preferred.

Physical Demands:

The physical demands described here are representative of those that must be met by the employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

· While performing the duties of this job, the employee is regularly required to stand, sit; talk, hear, and use hands and fingers to operate a computer and telephone keyboard reach

· Specific vision abilities required by this job include close vision requirements due to computer work

· Light to moderate lifting is required

Work Environment:

The work environmental characteristics described here are representative of those the employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

· Moderate noise (i.e. business office with computers, phone, and printers, light traffic).

· Ability to work in a confined area.

· Ability to sit at a computer terminal for an extended period of time.

Travel or Special Requirements:

Driving during the workday as well as local or out of state travel may be required to perform job duties.

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