Healthcare Enrollment Specialist

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Job description

Center for Family Health & Education (CFHE)

Job Description: Enrollment Specialist

Overview

The Enrollment Specialist supports the mission of the Center for Family Health & Education (CFHE) by expanding patient access to healthcare services through effective insurance enrollment and community outreach. This position assists patients and families with health insurance applications, renewals, and coverage maintenance across Medi-Cal, Covered California, and other public or private health programs. The Enrollment Specialist ensures that both patients and providers maintain continuous participation in insurance networks, promoting equitable access to high-quality, affordable care.

Primary Duties and Responsibilities

· Assist patients and families in understanding and applying for health coverage including Medi-Cal, Presumptive Medi-Cal, FPACT, EWC, and Covered California programs.

· Conduct eligibility screenings and ensure all required documentation is accurate and submitted promptly.

· Provide patient education and outreach on available health coverage options and preventive care benefits.

· Help patients maintain insurance coverage by assisting with renewals and re-determinations to prevent lapses.

· Support provider network participation by completing payer enrollment applications and ensuring timely renewals for Medi-Cal, Medicare, and commercial plans.

· Track and maintain accurate provider enrollment records and credentialing documentation to ensure compliance with payer requirements.

· Work with clinic and outreach teams to identify uninsured or underinsured patients and connect them to coverage or financial assistance programs.

· Attend and participate in community events, health fairs, and educational sessions to promote CFHE’s services and access to care initiatives.

· Respond to patient inquiries regarding insurance coverage, eligibility, and available programs in a professional and compassionate manner.

· Ensure confidentiality and compliance with HIPAA and CFHE privacy policies in all patient interactions.

· Document enrollment activities, outreach efforts, and patient interactions in the electronic health record (EHR) and submit accurate monthly reports.

Minimum Qualifications

· High school diploma or equivalent required; associate or bachelor’s degree preferred.

· At least two (2) years of experience in patient access, enrollment, or related healthcare administrative role, preferably in a Federally Qualified Health Center (FQHC).

· Certified Enrollment Counselor (CEC) certification required within 90 days of hire.

· Knowledge of Medi-Cal, Covered California, and other public assistance programs required.

· Proficiency with Microsoft Office and EHR systems (Athenahealth or NextGen preferred).

· Ability to communicate effectively with diverse populations; bilingual (English/Spanish) strongly preferred.

· Must possess a valid California driver’s license and reliable transportation for community outreach activities.

Required Skills and Abilities

· Excellent communication, interpersonal, and customer service skills.

· Strong organizational and time management abilities with attention to detail.

· Ability to work independently and as part of a multidisciplinary team.

· Commitment to serving underserved and diverse communities.

· Ability to handle sensitive patient information with discretion and confidentiality.

· Proactive and resourceful in identifying solutions to patient access barriers.

Working Conditions and Physical Requirements

· Work performed in a standard office or clinic setting with frequent computer and telephone use.

· Occasional travel to CFHE sites, community outreach events, and partner locations.

· Ability to stand, sit, and walk for extended periods.

· May occasionally lift or carry up to 25 pounds.

· Regular attendance and punctuality are essential functions of the position.

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CFHE Core Values

• Commitment to Service – Ensures efficient operations that support quality patient care and resource stewardship.
• Integrity and Accountability – Upholds transparency and compliance in all purchasing and inventory processes.
• Teamwork and Collaboration – Partners effectively with cross-functional teams to achieve organizational goals.
• Respect and Compassion – Supports CFHE’s mission by maintaining professionalism and empathy in all interactions.
• Excellence and Quality – Strives for operational excellence through research-driven, data-informed decisions.