Dedicated to the Health of the Community
The Health Care District of Palm Beach County is an integrated public health system established in 1988 as a special taxing district that is an equal opportunity employer of approximately 1 , 000 employees. The Health Care District's mission is to ensure access to a comprehensive health care system and the delivery of quality services for the residents of Palm Beach County. The Health Care District provides challenging and fulfilling employment opportunities through its health coverage programs for uninsured residents, a nationally recognized Trauma System, a School Health program which staffs registered nurses in nearly 170 public schools, a pharmacy operation, a long-term skilled nursing and rehabilitation center, and its acute care hospital, Lakeside Medical Center, in rural western Palm Beach County.
General Statement of Job
This position determines client eligibility for enrollment in the Coordinated Care Program of the Health Care District. Employees in this position are responsible for delivery of high quality customer service with attention to special needs of a diverse client base. Employees in this position interview persons in need of services and assist them in navigating the documentation process. Employees must apply technical knowledge to analyze application materials in order to make appropriate decisions regarding client eligibility and ensure appropriate application of policies and procedures. This position is responsible for meeting productivity and cycle time standards. Success in this position requires self-motivation and the ability to work independently with little to no daily supervision.
Specific Duties and Responsibilities
Evaluates all documentation related to the application process for compliance with eligibility policies and procedures and makes the applicant eligibility determination based on that evaluation. Reconciles errors in data when indicated to ensure accuracy of documentation.
Conducts effective interviews of clients utilizing appropriate techniques in order to compile financial and social history of clients and obtain necessary data for eligibility determination. Provides clear, comprehensible, and culturally appropriate instructions to applicants.
Takes appropriate action to reassure individuals who are upset to reduce their tension by using diplomacy and effective conflict resolution skills; demonstrates sensitivity to the needs of applicants and co-workers by applying appropriate interpersonal communication skills.
Enlists applicants’ cooperation in providing verification of financial resources through use of sensitivity and tact.
Purges cases approximately every 60 days.
Takes telephone calls from clients.
Acts as a liaison between applicants and other social service providers.
Assists the applicant in accurately completing the application for services; completes appropriate referral forms and applications to assist persons applying for other assistance.
Establishes and maintains excellent customer relations (both internal and external) by use of effective listening techniques, ascertaining the customer’s desires and objectives; anticipating customer needs; properly explaining requirements; and, giving high priority to customer satisfaction.
Requests and/or disseminates information, both verbally and in writing, to applicants, providers, employers, internal staff and local community agencies; independently generates appropriate, well-written, and grammatically correct correspondence.
Effectively prioritizes and manages processing of caseload by estimating, scheduling, tracking of time and activities, and initiating appropriate follow-up actions to meet productivity and cycle-time standards. Monitors case files until approval or denial of application is established. Reports all client encounters on log sheets.
Meets or exceeds individual productivity metrics, quality and timeliness standards as defined by department guidelines.
Instructs clients on procedures and policies; informs clients of programs available to assist in payment of medical bills.
Maintains self-motivation and independence in daily job performance with minimum supervision. Recommends ways to improve processes and business practices.
Represents the Health Care District in a highly professional manner projecting a positive impression in all client and health care provider contacts. Develops and maintains collaborative relationships with outside agencies responsible for providing verification of data.
Coordinates client services with caseworkers, County social workers, or other appropriate assisting agencies.
May provide interpreting services in a liaison capacity for the purpose of expediting access, assessment, and making the eligibility determinations or making referrals to other agencies for services.
Assists with the training of new employees, when necessary.
Ensures appropriate Primary Care Physician (PCP) assignment as requested by applicant.
Knowledge of all District and Healthy Palm Beaches’ lines of business as well as community, state and federal programs. Refer clients for community based services. Performs various administrative support tasks (such as data entry, memos, letters, and emails) in ensuring efficient work flow and accurate performance in functions under charge.
Emergency duty may be required of the incumbent that includes working in Red Cross shelters or to perform other emergency duties including, but not limited to, responses to threats or disasters, man-made or natural.
This job description reflects the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered as a complete description of all the work requirements and expectations that may be inherent in the position. The omission of specific statements of duties does not exclude them from the position. Management of the Health Care District of Palm Beach County reserves the right to assign duties not listed herein as necessary to accomplish the goals of the organization.
High school diploma or G.E.D required ; Associate’s degree with course work emphasis in social work, human services, or related field strongly preferred.
Three (3) to five (5) years previous experience or training that provides excellent knowledge of eligibility criteria for alternative government supported health care programs and benefits including Medicare, Medicaid, Social Security Disability CHAMPUS, Veteran’s Administration benefits, etc., and the ability to perform advanced administrative support functions required.
Valid Florida driver’s license required.
Multi-lingual ability (Spanish and Creole) strongly preferred.
The Health Care District is an Equal Employment Opportunity Employer and maintains a Drug Free Workplace. Qualified individuals with disabilities who require an accommodation to participate in the application process should contact Human Resources. Veterans preferred.
The Health Care District of Palm Beach County is an integrated public health system established in 1988 as a special taxing district that is...