Family Health Centers of San Diego · 19 hours ago
PACE Benefit Enrollment Specialist
San Diego, CA
Full-time
Onsite
Entry, Mid Level
$22/hr - $30.54/hr
2+ years expFamily Health Centers of San Diego is committed to providing high-quality health care and supportive services to underserved populations. The PACE Benefit Enrollment Specialist will review and evaluate health plan coverage for potential participants, ensuring compliance with PACE Program guidelines and maintaining meticulous records for accuracy in developing outcome reports.
Health CareHealth DiagnosticsMedical
Responsibilities
Review, assess, and evaluate health plan coverage of potential PACE Participants
Obtain insurance information to verify and validate coverage to determine allowable benefits
Analyze specifics of each health plan coverage related to Medicare, Medicare Advantage, Medicare Part D, Medi-Cal, private insurance, etc
Determine the calculated amount and timing of asset levels for Medi-Cal qualification
Explain, clarify, and define allowable parameters related to the PACE Program guidelines and regulatory Benefit Plan requirements
Explain, clarify, and provide possible recommendations, based on PACE Program guidelines and regulatory requirements in determining out-of-pocket costs
Ensure all questions and possible scenarios are covered and understood by all affected parties
Preserve confidentiality of all information collected and analyzed
Maintain meticulous records and information to ensure accuracy and completeness in developing outcome reports
Perform other duties as assigned
Qualification
Required
Bachelor's Degree in Business Administration or closely related field required
OR equivalent combination of education and experience that provides the skills, knowledge and ability to perform the essential job duties
Ability and means to travel as needed in a timely manner within San Diego County, to locations that may have limited access to public transportation; proof of liability and property damage insurance on vehicle used is required
DRIVER REQUIREMENTS: Licensed for a minimum of 3 years; No more than 2 violations and/or accidents within 3 years; No vehicle related suspensions/reinstatements; No DUI, reckless or felony Driving within 7 years
2 years of experience reviewing, evaluating, analyzing, or administering private and/or government-related healthcare benefit plans and programs
Strong analytical and problem solving skills
Possess critical thinking skills
Good understanding of private and/or government-related healthcare benefit plans and programs
Ability to multi-task, be flexible, ensure accuracy, and meet changing priorities in a fast-paced, high-workload environment
Demonstrated ability to capture, analyze, and interpret a wide array of data and information
Strong verbal and written communication skills to include the ability to interact with people in a variety of situations
Proficient level of experience with Microsoft Office applications to include Word, Excel, etc
Strong organizational skills, attention to detail, time-management skills, and strong motivation to meet deadlines and achieve goals
Company
Family Health Centers of San Diego
Family Health Centers of San Diego is a center that provides medical and healthcare services in multiple areas.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
$1MKey Investors
Health Resources and Services AdministrationCDA Foundation
2024-11-22Grant· $1M
2024-03-18Grant
Leadership Team
Das Vakamudi, PMP, SCPM
Chief Technology Officer
Laura Alvarado
Parent Partner-Program Support Partner
Recent News
2025-11-14
Company data provided by crunchbase