Medi-Cal Eligibility Services Coordinator

Tarzana Treatment Centers, Inc; Los Angeles (CA); On-site; USD 43,000 - 52,000; Full time

Benefits offered by this job

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

Job summary

Tarzana Treatment Centers, Inc. in Tarzana, CA is seeking a Medi-Cal Eligibility Services Coordinator to lead eligibility workflows from initial application through semiannual redeterminations.

The role ensures compliance with DHCS rules and AR requirements while coordinating with DPSS and BenefitsCal portals to maintain continuous coverage. The position requires 3+ years in Medi-Cal eligibility operations, strong regulatory knowledge, and the ability to train staff on HIPAA and state privacy

Qualifications

• Three or more years of direct Medi-Cal eligibility, enrollment, and semiannual redetermination workflows.
• Strong knowledge of federal Medicaid requirements, California Medi-Cal rules, and DHCS guidance.
• Hands-on experience with DPSS processes, BenefitsCal/CBO portal tools, and EHR systems.

Responsibilities

• Lead staff in screening patients for Medi-Cal eligibility and facilitating SSApp submission via Benefits Cal and DPSS channels.
• Ensure timely determinations and compliant enrollment with federal and California requirements.
• Develop processes to minimize gaps in coverage and support semiannual redeterminations and renewals.
• Coordinate with county eligibility workers to maximize ex-parte renewals and resolve eligibility issues.
• Oversee completion of Medi-Cal Renewal Forms and supporting verifications within statutory timelines.
• Enforce AR requirements, including MC 382 and MC 383 forms, and conflict-of-interest disclosures.
• Train staff on Medi-Cal workflows, HIPAA, privacy requirements, and approved signature methods.

Skills

Medi-Cal eligibility coordination

Regulatory compliance

Patient enrollment support

Education

High school diploma

Bachelor's degree preferred

Tools

BenefitsCal portal

DPSS processes

CBO portal

EHR systems

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

Admissions/Intake Regular Full time Clerical Tarzana, CA, US

30+ days ago Requisition ID: 2316

Salary Range: $31.52 To $37.83 Hourly

Position Title: Medi-Cal Eligibility Services Coordinator

Department: Admissions

Reports To: Admissions Supervisor

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

• 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.

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

High School degree required. Bachelor's degree in Healthcare Administration, Social Work, Public Health, or related field 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.