Eligibility & Coverage Advocate at WelbeHealth
Overview
WelbeHealth seeks an Eligibility & Coverage Advocate to lead participant benefit management. This role drives seamless eligibility maintenance for Medi-Cal and related programs. Responsibilities include proactive identification of redetermination needs and coordination across teams. The ideal candidate thrives in fast-paced environments while delivering precise outcomes within 90 days.
What You'll Do9
- 1Identify participants nearing Medi-Cal redetermination deadlines
- 2Educate participants on form completion and signature acquisition
- 3Conduct home visits to gather required documentation
- 4File and track applications through proper channels
- 5Maintain relationships with DPSS for policy compliance
- 6Support E&R team with prioritization of urgent requests
- 7Drive resolution of eligibility disputes
- 8Collaborate with internal teams to expedite processing
- 9Ensure adherence to state and federal regulations
Requirements7
- 1High school diploma or equivalent
- 2Three years of Medi-Cal enrollment experience
- 3Proficiency in eligibility case management systems
- 4Bilingual Mandarin/English communication skills
- 5Strong written and verbal communication abilities
- 6Experience with appeals processes and share of cost calculations
- 7Familiarity with DHCS and CMS policies
Salary Insight
Salary not disclosed in listing
Location
Required Skills
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