Patient Access and Eligibility Specialist

The Patient Access & Eligibility Specialist supports patient access to care by screening patients for eligibility under the

sliding Fee Discount Program (SFDS), ensuring required documentation is collected and updated, and assisting eligible

patients in applying for Medicaid, CHIP, and other insurance programs. This role plays a vital part in reducing barriers to

care and supporting the financial sustainability of the health center.

ROLE AND RESPONSIBILITIES

Sliding Fee Discount Program (SFDS)

• Screen patients based on income and household size to determine eligibility for discounted services under the SFDS policy.
• Collect and verify required documentation, maintain confidentiality, and update records annually or as needed.
• Educate patients on the sliding fee scale and how discounts are applied.

Insurance Enrollment & Eligibility

• Assist eligible patients in completing and submitting applications for Medicaid, CHIP, marketplace insurance, or
• other available coverage options.
• Provide follow-up support to ensure applications are processed and insurance coverage is activated.
• Maintain knowledge of current insurance options and enrollment criteria.

Patient Navigation & Outreach

• Provide culturally sensitive guidance and assistance to patients who may have difficulty understanding insurance
• or discount program processes.
• Coordinate with clinical and front office staff to ensure patients are connected to services without delay.
• Participate in outreach activities, enrollment events, and health fairs as needed.

Compliance & Documentation

• Ensure compliance with HRSA requirements, state and federal regulations, and FQHC policies regarding patient
• eligibility and data privacy.
• Accurately document all activities in the electronic health record (EHR) and other tracking systems.
• Complete required training and certification for enrollment assistance programs, if applicable.

Other Duties

• Other duties as assigned.

• High school diploma or equivalent required; associate degree or higher in social services, public health, or a
• related field preferred.
• Minimum one year of experience in patient registration, eligibility screening, or health insurance enrollment
• preferred.
• Bilingual (English/Spanish or other relevant language) required.
• Knowledge of Medicaid, Affordable Care Act plans, and FQHC sliding fee discount practices a plus.
• Excellent communication, interpersonal, and organizational skills.
• Ability to maintain confidentiality and interact respectfully with patients from diverse backgrounds.