At WelbeHealth, we serve our communities’ most vulnerable seniors through shared intention, pioneering spirit, and the courage to love. These core values and our participant-focus lead the way no matter what.

The Eligibility and Coverage Coordinator is accountable for assisting the Outreach and Enrollment (O&E) team and prospective enrollees with eligibility discrepancies, as well as supporting the Eligibility and Reconciliation (E&R) team functions as assigned.

This role is different because the Eligibility and Coverage Coordinator at WelbeHealth:

Plays a critical role in securing life-sustaining coverage for vulnerable seniors, working hand-in-hand with Medi-Cal, Medicare, and Social Security agencies to remove barriers so participants can access comprehensive PACE services without interruption
Operates at the intersection of outreach, enrollment, eligibility, and revenue cycle, giving this role broader visibility and impact than traditional eligibility positions, and directly influencing program access and participant experience

We care about our team members. That’s why we offer:

Medical insurance coverage (Medical, Dental, Vision)
Work/life balance - We mean it! 17 days of personal time off (PTO), 12 holidays observed annually, and 6 sick days
401K savings + match
Comprehensive compensation package including base pay, bonus, and equity
And additional benefits!

On the day-to-day, you will:

Resolve any enrollment and eligibility issues with SSI, Medi-Cal, and Medicare
Collaborate proactively with the county Medi-Cal, Social Security Administration staff, and Department of Health Services staff to resolve eligibility challenges
Comprehend, monitor, and use state systems (e.g., POS and AEVS, MARx) effectively
Monitor WelbeHealth participants’ benefit statuses for application denials, eligibility discontinuances, and annual redetermination dates
Oversee participant placement transitions and obtain changes in benefits from SSA and/or Medi-Cal as applicable
Collaborate with O&E, Reconciliation leadership, and Eligibility Specialists to provide feedback on revenue collection, cap recovery, and retroactive payment projections

Job requirements include:

High school diploma or equivalency
Minimum of two (2) years of experience in a healthcare administrative support role
Proficiency with Microsoft Excel, Word, and Outlook
Experience with local government Medicaid or Social Security agencies preferred
Highly motivated, self-directed, able to execute tasks in a quickly changing environment, and make sound decisions in emergency situations
Excellent organizational, customer service, and communication skills in settings with seniors

We are seeking an Eligibility and Coverage Coordinator that ideally has healthcare administrative support experience. If you’re ready to join a holistic care team that values both its participants and providers, we’d love to hear from you

Salary/Wage base range for this role is $24.39 - $32.20 hourly + Bonus. WelbeHealth offers competitive total rewards package that includes, 401k match, healthcare coverage and a broad range of other benefits. Actual pay will be adjusted based on experience and other qualifications.

Compensation

$24.39—$32.20 USD

COVID-19 Vaccination Policy

At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all our employees and proof of vaccination, or a vaccine declination form will be required prior to employment. WelbeHealth maintains required infection control and PPE standards and has requirements relevant to all team members regarding vaccinations.

Our Commitment to Diversity, Equity and Inclusion

At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.

Beware of Scams

Please ensure your application is being submitted through a WelbeHealth sponsored site only. Our emails will come from @welbehealth.com email addresses. You will never be asked to purchase your own employment equipment. You can report suspected scam activity to [email protected]

Eligibility and Coverage Coordinator

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