Southwest Care Center employees can answer yes to these 3 questions:

1. Do you want to make a difference

2. Do you believe everyone is entitled to quality healthcare

3. Do you desire to serve the underserved in your community

For over 25 years Southwest Care Center has been providing exceptional healthcare to the communities of Santa Fe and Albuquerque NM. We are a non-profit FQHC-LAL providing medical behavioral health case management community outreach diabetes education and pharmacy services. We are proud to offer gender equity medicine syringe exchange and HIV/HepC treatment testing and other services within our communities.

Southwest Care Center is currently seeking full-time Eligibility and Enrollment Specialist to support our Jefferson Clinic in Albuquerque NM.

Position Details:

Under the direction of the Ancillary Services Manager the Eligibility and Enrollment Specialist is responsible for the patient insurance verification process to ensure proper payment from insurers and to provide assistance that reduces out-of-pocket expenses related to all services performed in a clinical setting including HIV/HCV services and PrEP/Sexual Health services. The specialist assesses and enrolls patients in assistance programs for which they qualify interprets and applies the sliding fee scale and ensures that all related documentation is accurately and consistently recorded in the electronic medical record. Additionally the specialist enrolls eligible patients into the Ryan White HIV/AIDS Program case management services and assigns them to a case manager. They ensure patients are scheduled for services track open referrals to support proper follow-through of appointments and maintain cross-departmental support and collaboration.

Position responsibilities include but not limited to:

Assess and enroll eligible patients into Ryan White HIV/AIDS Program case management services at intake.

Determine the patients level of Ryan White Sliding Fee Scale and Cap on Charges and educate patients about these benefits.

Assign the patient to the appropriate specialty provider or facility based on the patients current medical needs as defined by the primary care provider.

Provide all the required medical history information regarding the patient to the specialty provider or facility.

Coordinate with insurance carriers and specialty practices to obtain prior authorizations pre certifications and referrals on applicable plans which include HMO PPO and POS health plans and documents all benefit information into the patients electronic medical record.

Attend weekly specialty services meetings as assigned.

Scheduling diagnostic testing for HCV patients if applicable

Scheduling HCV patient medication shipment if applicable

Coordinating HCV patient prior authorization if applicable

Maintain contact with patient to ensure compliance with HCV program requirements.

Schedule necessary provider visits for patients if needed

Assist with HOPWA certifications if applicable

HOPWA reporting if assigned

Weekly Monthly and Quarterly reporting as assigned

Weekly food pantry inventory/ordering as assigned

Other duties as assigned.

Candidate Highlights:

• Minimum high-school diploma and minimum 1 year working in a similar role of enrollment and or referrals. Prefer bachelors and 3 years working in enrollment and/or referral role supporting populations as described in this description.

• Valid Drivers License Basic Life Support (BLS) NMDOH HIV/HCV testing certification within 12 months of hire.

Employment Highlights:

• Monday - Friday schedule.

• Competitive rate of pay.

• Great work/life balance with generous time off plans.

• Tuition reimbursement availability.

• Full benefits package including medical dental vision 401k paid time off professional development programs and 340B prescription access with substantial employer contribution.

Interested in this Position Need More Information

Apply today and we will connect you with a member of our recruitment team. We look forward to speaking with you soon.

If you experience difficulty applying or need assistance please contact .

*Please note we are unable to respond to resume inquiries.

Living & Working in New Mexico:

The Land of Enchantment offers residents a way of life that you wont find anywhere else in the United States. Our clinic locations are in Santa Fe and Albuquerque NM. Each with its own unique vibe and both offering all the perks you get when you call New Mexico Home.

• Rich cultural and historical diversity.

• 310 daysof sunshine combined with a mild dry climate and four distinct seasons! Youll forget what humidity is when you live here.

• Unlimited year-round outdoor opportunities including hiking rock-climbing rafting motorized sports and even skiing. Yes we have really big ski mountains in and around the deserts of New Mexico!

• Diverse and inclusive communities with amazingly kind people from all walks of life.

• Gorgeous landscapes that include desert and majestic mountains. New Mexico has to be to be seen to believe.

• Continuous festivals concerts and events including the internationally known Balloon Fiesta of Albuquerque.

• International airport providing low-cost quick access in-country and out.

• Big city amenities found in Albuquerque with easy access from Santa Fe (50 min). Many of our employees commute between these cities. Both cities are connected by the NM rail system for those looking for a relaxing commute with a breath-taking view.

• Great schools and family friendly communities.

• And lets not forget about New Mexican cuisineit is some of the best food in the country. Will you have red or green

Southwest Care Center is an equal opportunity employer. We offer equal employment opportunities to employees and applicants without regard to race color religion sex agenational origin disability status protected veteran status sexual orientation gender identity or any other characteristic protected by federal or state law.

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