Medi-Cal Eligibility Specialist Lead

Job Summary: The Medi-Cal Eligibility Specialist Lead will support the daily operations of specific work units within the Registration and Patient Access Department, working closely with the Medi-Cal Manager to provide guidance, coverage, and presence to the Medi-Cal Specials work units. Ensures effective operations through organizing, scheduling, and monitoring department workload, as well as monitoring work quality and productivity metrics and coordinates training as needed. Serves as the first line of escalation for staff questions on workflows and processes, and is responsible for mentoring new staff, assisting in the planning and development of training materials and in the development and implementation of quality assurance processes. Is responsible for ensuring the effective operations for the day-to-day activities of Medi-Cal Eligibility and uninsured/underinsured processes. Identifies areas for improvements and assist in developing plans for improving quality of these processes. Performs other duties as needed.

Education and Experience: Minimum three years of hospital-based Medi-Cal application preparation, Newborn Gateway, and Hospital Presumptive Eligibility experience required. Minimum four years of healthcare registration experience required.

Knowledge and Skills: Knowledge of private and government healthcare payers, Medi-Cal terminology, and regulations associated with hospital revenue cycle performance. Knowledge and understanding of standard registration workflows and healthcare compliance regulations. Able to read, write legibly, and speak in English with professional quality; use computer, printer, and software programs necessary to the position (e.g., Word, Excel, Outlook, PowerPoint, EPIC, State and Federal computer). Operate/troubleshoot basic office equipment required for the position. Relate and communicate positively, effectively, and professionally with others; work calmly and respond courteously when under pressure; collaborate and accept direction. Think critically; manage multiple assignments effectively; organize and prioritize workload; work well under pressure; problem solve; recall information with accuracy; pay close attention to detail; work independently with minimal supervision. Distinguish colors as necessary; hear sufficiently for general conversation in person and on the telephone and identify and distinguish various sounds associated with the workplace; see adequately to read computer screens, and written documents necessary to the position.

Licensures and Certifications: Certification from the Department of Social Service in Hospital Presumptive Eligibility, Newborn Gateway Presumptive Eligibility, Children’s Presumptive Eligibility, and Presumptive Eligibility for Pregnant Women required.