Eligibility Coordinator

La Familia; Hayward (CA); On-site; USD 42,000 - 62,000; Full time

Benefits offered by this job

Health benefits

Paid time off

Professional development

Flexible scheduling

Growth opportunities

Job summary

La Familia is seeking an Eligibility Enrollment Clerk to support front office operations at its Community Health Center. You will prepare eligibility information, verify insurance, and enroll patients in public and private programs while guiding them through the intake process.

You will register patients, schedule visits, and document data in the EHR, ensuring HIPAA-compliant handling of sensitive information. Bilingual English/Spanish is strongly preferred to serve diverse communities.

Qualifications

• High school diploma or GED required; Associate’s Degree preferred.
• Minimum three years of experience in patient registration, insurance verification, eligibility determination, or enrollment.
• Experience in a community health care environment, FQHC, or primary health care setting preferred.
• 2–3 years of experience with Medi‑Cal eligibility, Covered California enrollment, and other public/private insurance programs.
• Bilingual (English/Spanish or other community language) strongly preferred.
• Proficiency in EHR and eligibility verification systems.
• Excellent customer service and communication skills with underserved populations.
• Proficient in MS Office and Google Workspace.
• Valid California driver’s license required.

Responsibilities

• Prepare eligibility information for each scheduled clinic patient and verify eligibility with front desk staff.
• Interview and screen patients to determine eligibility for health insurances and assistance programs.
• Register new patients, schedule appointments, and provide information on services.
• Enter and document eligibility data in the electronic health record.
• Assist patients in completing and submitting applications for county and state benefit programs.
• Maintain confidential records in accordance with HIPAA and handle sensitive information.
• Travel may be required for eligibility-related meetings.

Skills

Patient registration

Insurance verification

Eligibility determination

Enrollment processing

Bilingual (English/Spanish)

Customer service

MS Office

Google Workspace

HIPAA compliance

Education

High school diploma or GED

Associate’s Degree preferred

Tools

Electronic Health Records (EHR)

Eligibility verification systems

Job description

Position Overview

As part of La Familia’s Community Health Center front office team, this role prepares and submits required eligibility screening and information for all patient visits. The position reports to the Clinic Director/Administrator and works closely with Finance, external CRM vendors, and health center staff to enroll patients in private and public health care assistance programs and serve as patient registrar and navigator.

Essential Job Functions and Responsibilities

• Prepare eligibility information for each scheduled clinic patient at least two days prior to the appointment.
• Collaborate with front desk staff to verify eligibility for scheduled and non‑scheduled patients.
• Interview and screen new and established patients to determine eligibility for health insurances and assistance programs.
• Serve as the first point of contact for patients seeking enrollment in primary care services.
• Enter and document patient messages, eligibility data, and alerts in the electronic health record.
• Assist patients and community members in completing and submitting applications for county and state benefit programs.
• Register new patients, schedule appointments, and provide information on La Familia’s services and programs.
• Track and report enrollment and outreach data to support program goals and compliance.
• Conduct follow‑up with prospective patients via phone, email, and in‑person contact to guide enrollment from inquiry to intake completion.
• Maintain accurate statistical records, reports, and tracking systems for enrollment activities.
• Attend eligibility‑related meetings and share information with clinic personnel; travel may be required.
• Pursue and complete training to become a Certified Enrollment Counselor.
• Adhere to federal and state regulations governing eligibility determination.
• Participate in eligibility department audits, trainings, and compliance activities.
• Maintain confidential records in accordance with HIPAA and handle sensitive financial/insurance information.
• Participate in community outreach events and promote enrollment services.
• Provide interpretation and navigation support for limited‑English‑proficiency patients.
• Lead and collaborate on projects supporting agency objectives.
• Perform other duties and projects as assigned.

Qualifications & Experience

• High school diploma or GED required; Associate’s Degree preferred.
• Minimum three years of experience in patient registration, insurance verification, eligibility determination, or enrollment.
• Experience in a community health care environment, FQHC, or primary health care setting preferred.
• 2‑3 years of experience with Medi‑Cal eligibility, Covered California enrollment, and other public/private insurance programs.
• Bilingual (English/Spanish or other community language) strongly preferred.
• Strong understanding of healthcare eligibility requirements, including Medi‑Cal, Medicare, commercial plans, and sliding fee scales.
• Knowledge of HRSA health center program requirements for patient eligibility and sliding fee discount programs.
• Proficiency in Electronic Health Records (EHR) and eligibility verification systems.
• Excellent customer service and communication skills, especially with underserved and diverse populations.
• Proficient in MS Office and Google Workspace.
• Valid California driver’s license required.

Benefits

• Health benefits: medical, dental, and vision with 95% employee and 80% dependent premium contributions; employer‑paid life insurance.
• Paid time off: 15 holidays, 12 paid sick days, and vacation time.
• Employee Assistance Plan for wellness and financial support.
• Pet plan benefits, including veterinary discounts and telehealth services.
• 403(b) retirement plan.
• License and certification renewal reimbursement.
• Work‑life balance support and flexible scheduling options.
• Opportunities for growth and professional development.