Eligibility Specialist/Grants Assistant

Company Overview

Established over 50 years ago, Project Reality partners with Salt Lake County and Utah State to deliver services that impact the underlying causes of chronic disease and improve community health outcomes. We are a fully integrated health clinic providing comprehensive substance use disorder, primary care, and mental health treatment for vulnerable populations not adequately served in traditional health care settings. Our health home model addresses critical health determinants through a team-based approach utilizing medical providers, therapists, case managers, and peer coaches. Team members are offered tremendous opportunities for professional growth and development and we take pride in our supportive and dynamic environment.

Summary

We are seeking an Eligibility Specialist/Grants Assistant to join our team at Project Reality. In this role, you will play a vital part in assisting individuals in accessing the services they need for recovery and wellness. Your contributions will directly support our mission of helping clients achieve their full potential.

Responsibilities

• Verify patient insurance coverage and eligibility prior to appointments, ensuring accurate information is entered into the electronic health record system.
• Assist patients in reviewing, applying for, and coordinating with Medicaid and other health insurance providers to ensure continued insurance coverage.
• Communicate patient financial responsibilities (e.g., copays, deductibles, non-covered services) when appropriate.
• Obtain and scan insurance cards, photo IDs, and signed intake forms related to billing and HIPAA.
• Ensure demographic and insurance information is accurate and up to date at every visit.
• Collaborate with billing department to ensure required documentation for claim submission is complete and accurate
• Monitor and resolve insurance eligibility denials in partnership with billing staff, such as coordination of benefits and eligibility denials.
• Consistently use the Patient Alerts & Restriction system in Netsmart to ensure patients are followed up with daily/weekly on GPRA/SPARS re-assessments and/or satisfaction surveys.
• Perform patient reassessments according to grant outlined timeframes.
• Maintain client records appropriately to ensure all paperwork/documentation is completed as required (may also include tracking of behavioral or medical results).
• Document patient encounters the same day as service provided.
• Attend staff meetings and individual/group supervision.
• Provide backup for: Intake Calls/appointment setting, Case Manager, Support Staff.
• Input data into the federal grant monitoring system.
• Oversee and develop tracking strategies and insure compliance with grant standards.
• Work in conjunction with the grant project directors and data analyst to meet grant and reporting requirements.

Requirements

• High school diploma.
• Strong organizational and communication skills.
• 2 years of experience in eligibility determination and insurance verification.
• Strong data entry skills with high attention to detail and accuracy.
• Previous experience in grants management, reporting, or compliance (federal or state grants preferred).
• High level of professionalism and collaboration.
• Basic Microsoft Office/Excel skills.
• If in recovery, must have at least 2 years of continuous sobriety.
• Ability to pass/maintain a BCI Clearance Check.

If you are passionate about making a difference in the lives of others and want to be part of a supportive community, we invite you to apply for the Eligibility Specialist/Case Manager position at Project Reality today!

Job Type: Full-time

Pay: $24.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Professional development assistance
• Retirement plan
• Vision insurance

Experience:

• Insurance Eligibility: 1 year (Required)
• Insurance verification: 1 year (Required)

Work Location: In person

Salary : $24