Care Coordination & Insurance Eligibility Specialist

Roots Through Recovery; Long Beach (CA); On-site; USD 52,000 - 68,000; Full time

Job summary

Roots Through Recovery in Long Beach, CA seeks an Eligibility Specialist / Care Coordinator to verify Medi-Cal and managed care benefits, renewals, and documentation to prevent treatment interruptions.

You'll coordinate with county agencies, health plans, and referral sources, and support clinical, admissions, and billing teams while maintaining HIPAA compliance and accurate EHR records.

Qualifications

• Minimum 1 year in healthcare eligibility, insurance verification, case management, care coordination, admissions, behavioral health, or related field preferred.
• Experience verifying Medi-Cal, Drug Medi-Cal, commercial insurance, or managed care benefits preferred.

Responsibilities

• Verify and maintain client insurance eligibility and benefits throughout treatment.
• Monitor client eligibility status to ensure compliance with SAPC, DHCS, Drug Medi-Cal, and health plan requirements.
• Proactively identify clients whose insurance or eligibility is at risk of lapsing and initiate follow-up.
• Assist clients with completing eligibility renewals, recertifications, and required documentation.
• Coordinate with county agencies, managed care plans, Medi-Cal offices, and other entities to resolve eligibility issues and prevent interruptions in treatment.
• Verify insurance benefits, obtain authorizations when applicable, and communicate benefit information to staff.
• Monitor insurance verification reports and maintain accurate records of eligibility status and benefit information.
• Educate clients regarding insurance requirements, renewal deadlines, and documentation needed to maintain eligibility.
• Collaborate with admissions, counselors, case managers, billing staff, and leadership to ensure clients remain eligible for services.
• Document all eligibility verification activities in EHR and tracking systems.
• Maintain accurate tracking spreadsheets, reports, and documentation related to insurance eligibility and client enrollment.
• Assist clients with referrals to community resources when needed to maintain healthcare coverage.
• Maintain confidentiality of all client information per HIPAA and agency policies.
• Participate in team meetings, trainings, audits, and compliance reviews.
• Perform general administrative and care coordination duties as assigned.

Skills

Healthcare eligibility

Attention to detail

Communication

Multitasking

Education

High school diploma or equivalent

Associate degree in Healthcare Administration or related field

Tools

EHR systems

Insurance verification portals

Job description

Roots Through Recovery in Long Beach, CA seeks an Eligibility Specialist / Care Coordinator to verify Medi-Cal and managed care benefits, renewals, and documentation to prevent treatment interruptions.

You'll coordinate with county agencies, health plans, and referral sources, and support clinical, admissions, and billing teams while maintaining HIPAA compliance and accurate EHR records.