Medi-Cal Eligibility Services Coordinator

Tarzana Treatment Centers, Inc.; California, Northern (MO, KY); Hybrid; USD 40,000 - 51,000; Full time

Benefits offered by this job

Medical Insurance

Vision Care Plan

Life Insurance

Paid Holidays

Flexible Spending Account

Paid Vacation Time

Sick Time

401(k) Retirement Plan

Continuing Education Opportunities

Job summary

Tarzana Treatment Centers, Inc. is seeking a Medi-Cal Eligibility Services Coordinator in Tarzana, CA.

The role leads the process to help patients obtain and maintain Medi-Cal coverage from initial application through semiannual renewals, ensuring strict DHCS AR compliance and priority on timely determinations. The position reports to the Supervisor of Admissions within the Admissions department and participates in ongoing staff training on HIPAA and privacy standards.

Qualifications

• Bachelor’s degree in Healthcare Administration, Social Work, Public Health, or related field; Master’s preferred.
• Three (3) or more years of direct Medi-Cal eligibility, enrollment, and semiannual redetermination workflows within a healthcare or community based organization setting.

Responsibilities

• Lead staff in Medi-Cal eligibility screening and facilitating the completion and submission of the SSApp via Benefits Cal and DPSS channels.
• Ensure application and eligibility workflows support timely determinations, low-barrier enrollment, and compliance with applicable federal and California requirements.
• Oversee Medi-Cal redeterminations, renewals, and change-of-circumstance processing, coordinating with county eligibility workers.
• Enforce AR requirements and DHCS rules, including conflict-of-interest disclosures and Authorized Representative procedures.
• Train Admissions and related staff on Medi-Cal eligibility workflows, HIPAA, privacy requirements, and data security.

Skills

Medi-Cal knowledge

Compliance

Communication

Stakeholder coordination

Education

Bachelor’s degree in Healthcare Admin/Social Work/Public Health

Master’s degree preferred

Tools

BenefitsCal portal

DPSS systems

Electronic Health Records

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Medi-Cal Eligibility Services Coordinator

Regular Full time Clerical Tarzana, CA, US

3 days ago Requisition ID: 2316

Salary Range: $29.58 To $37.02 Hourly

Position Title: Medi-Cal Eligibility Services Coordinator

Department: Admission

Reports To: Supervisor of Admissions

POSITION SUMMARY

The Medi-Cal Eligibility Services Coordinator is responsible for leading TTC’s strategy to assist patients in achieving, maintaining, and re-establishing Medi-Cal coverage. This position oversees the full lifecycle of Medi-Cal eligibility from initial application and onboarding through semiannual recertification/redetermination cycles and change-of-circumstance processing.

The Medi-Cal Eligibility Services Coordinator ensures all eligibility and redetermination workflows comply with state and federal mandates, this role strictly enforces TTC's compliance with DHCS Authorized Representative (AR) rules and conflict-of-interest requirements.

Benefits Package

• Medical Insurance
• Vision Care Plan
• Life Insurance
• Paid Holidays
• Flexible Spending Account (FSA)
• Paid Vacation Time
• Sick Time
• 401(k) Retirement Plan
• Competitive wages
• Stability and career advancement
• Continuing Education Opportunities

CATEGORIES OF DUTIES

1. Medi-Cal Initial Eligibility & Continuous Coverage Management

• Lead staff in screening patients for Medi-Cal eligibility and facilitating the completion and submission of the Single Streamlined Application (SSApp) via Benefits Cal and DPSS channels.
• Ensure application and eligibility workflows support timely determinations, low-barrier enrollment, and compliance with applicable federal and California requirements.
• Develop and maintain proactive processes to reduce administrative or procedural loss of coverage and minimize gaps in patient eligibility.
• Oversee TTC’s operational workflow for required Medi-Cal redeterminations and renewals, including applicable semiannual cycles.
• Coordinate with county eligibility workers to maximize ex-parte renewals and resolve eligibility issues before coverage is interrupted.
• Oversee patient completion and signing of Medi-Cal Renewal Forms (e.g., MC 210 RV) and Statement of Facts forms (SAWS 2). Ensure income, household, and activity verifications are submitted within state-mandated timeframes.
• Enforce procedures following procedural discontinuances within the 90-day cure period, submitting required documentation promptly to rescind notices of action without requiring a full re-application.
• Ensure required changes in income, household size, or address are reported to the Department of Public Social Services (DPSS) within statutory deadlines, establishing new 6-month renewal dates upon completion of redeterminations as specified by DHCS guidelines.
• Audit and respond to county Notices of Action (NOAs) regarding denials, share-of-cost changes, or discontinuances
• Assist patients with State Fair Hearing requests and coordinate or provide Authorized Representative support during the appeals process, as permitted.
• Promote patient understanding of eligibility decisions, appeal rights, and available options for maintaining coverage.

4. Authorized Representative (AR) Implementation & Compliance

• Enforce mandatory completion and patient signature of the Appointment of Authorized Representative form (MC 382) prior to taking official action on a case.
• Oversee completion of the Authorized Representative Standard Agreement for Organizations (MC 383), designating up to three authorized TTC employees per patient file.
• Enforce strict compliance with the Political Reform Act and DHCS rules by delivering written conflict-of-interest disclosures to patients prior to acting as AR, ensuring recommendations serve the patient’s best health interest rather than TTC’s financial benefit.
• Ensure patients are informed of their right to modify or revoke AR representation at any time, orally or in writing.

5. Benefits Cal Portal & Data Systems Management

• Oversee secure batching and uploading of eligibility documents, MC 382, and MC 383 forms into the Community-Based Organization (CBO) BenefitsCal portal.
• Enforce standard naming conventions (e.g., ClientName_DocumentType_Date) and PDF/image quality standards. Ensure digital confirmation receipts are saved in internal Electronic Health Records (EHR).
• Enforce the mandatory 7-day waiting period post-portal submission before initiating status inquiries with assigned DPSS eligibility offices.

6. Training, Data Security & Scope Boundaries

• Train Admissions, Intake, and other applicable staff on Medi-Cal eligibility workflows, renewal processes, Authorized Representative requirements, and approved signature methods.
• Educate staff regarding HIPAA, state privacy requirements, DHCS guidance, and appropriate handling of sensitive eligibility information.
• Ensure staff do not request, access, retain, or disclose patient information outside approved workflows or business needs.
• Develop consistent procedures, job aids, and quality-control practices to support accurate and compliant eligibility operations.

EDUCATION

• Bachelor’s degree in Healthcare Administration, Social Work, Public Health, or related field. Master's preferred;
• Three (3) or more years of direct experience managing Medi-Cal eligibility, enrollment, and semiannual redetermination workflows within a healthcare or community based organization setting.

EXPERIENCE

• Strong working knowledge of federal Medicaid requirements and California Medi-Cal eligibility rules, regulations, and DHCS guidance.
• Working knowledge of Authorized Representative requirements, patient rights, informed consent, privacy, and conflict-of-interest standards.
• Hands‑on experience with DPSS processes, BenefitsCal/CBO portal tools, SAWS-related systems, and electronic health record systems.
• Strong organizational, analytical, communication, and problem‑solving skills with the ability to manage deadlines and multiple eligibility workflows.
• Ability to collaborate effectively with county eligibility staff, internal departments, patients, and organizational leadership.

SETTING

Tarzana Treatment Centers, Inc. is a non‑profit corporation, which provides behavioral healthcare services, including substance use dependency.

EQUAL EMPLOYMENT OPPORTUNITY

Tarzana Treatment Centers, Inc. is an equal opportunity employer and does not discriminate based on race, national origin, religion, gender, sexual orientation, disability, or any other characteristic protected by federal, state, or local law.

ADA REQUIREMENT

Tarzana Treatment Centers, Inc. supports the Americans with Disabilities Act. Discrimination is prohibited in all aspects of employment against disabled persons, who, with reasonable accommodations, can perform the essential functions of a job.