Medi-Cal Benefits Coordinator

$53,269 - $63,918/Yr

WelbeHealth - Los Angeles, CA

Full-time - Mid Level

Los Angeles, CA

Social Assistance

About the position

The Medi-Cal Benefits Coordinator at WelbeHealth serves as a vital liaison between participants and the WelbeHealth center team, focusing on assisting enrolled participants in maintaining their eligibility for state and federal benefits, including SSI, Medicaid, and Medicare. This role is essential in supporting the Eligibility & Reconciliation (E&R) team to ensure that eligibility issues are resolved accurately and promptly. The coordinator will work with minimal direction, prioritizing daily work requests and managing turnaround times for inquiries and escalations. A key responsibility of the Medi-Cal Benefits Coordinator is to proactively identify participants who are approaching Medi-Cal redetermination. This involves educating and assisting participants in completing necessary forms, ensuring that all required signatures are obtained. The coordinator may need to conduct home visits to facilitate the completion of forms and assist in gathering all documentation necessary for eligibility determination and redetermination. Additionally, the coordinator will be responsible for completing and filing applications, maintaining follow-up with participants, center staff, and government agencies to ensure timely processing of all mandated applications and accompanying documentation. The role also requires maintaining a strong working relationship with the Department of Public and Social Services (DPSS) to ensure compliance with the policies and procedures set forth by the Department of Health Care Services (DHCS) and the Centers for Medicare & Medicaid Services (CMS). This position is crucial in ensuring that participants receive the benefits they are entitled to, thereby enhancing their quality of life and access to necessary healthcare services.

Responsibilities

• Proactively identify participants coming up for Medi-Cal redetermination.
• Educate and assist participants in completing necessary forms and obtaining appropriate signatures.
• Conduct home visits to participants when necessary to complete forms.
• Assist with obtaining all documentation required for eligibility determination/redetermination.
• Complete and file applications for benefits.
• Initiate and maintain proper follow-up with participants, center staff, and government agencies to ensure timely processing of applications.
• Maintain a strong working relationship with the Department of Public and Social Services (DPSS) to ensure compliance with DHCS and CMS policies.

Requirements

• High School Diploma or Equivalency.
• Minimum three years of relevant Medi-Cal/Medicaid enrollment experience, including share of cost, spousal impoverishment protections, and appeals processes.
• Experience working directly with the county DPSS submitting, managing, and appealing Medi-Cal enrollments.
• Demonstrate in-depth experience with complex Medi-Cal enrollment case management and knowledge of Medi-Cal rules, processes, and practices.
• Bilingual (Spanish/English) strongly preferred.
• Strong personal interaction skills, comfortable speaking to seniors in a caring and comforting manner.

Benefits

• 401k matching
• Medical insurance coverage (Medical, Dental, Vision) starting day one of employment
• 17 days of personal time off (PTO)
• 12 holidays observed annually
• Sick time
• Bonus
• Equity