Lead Bilingual Eligibility Specialist - Montrose Allen Parkway

Join our family as an Eligibility Specialist Lead and help connect patients with the healthcare services they need. In this meaningful role, you will determine eligibility for third-party reimbursement, support new patient admissions, ensure accurate insurance billing codes, and respond to questions from prospective applicants and patients.

You will be a trusted resource for patients, teammates, and Management. Your compassion, organization, and attention to detail will help create a respectful, patient-centered experience, while your leadership will support a strong and capable Eligibility team across multiple clinic locations.

• Help patients navigate eligibility, insurance coverage, and access to community healthcare services.
• Support accurate reimbursement and billing processes that strengthen the healthcare delivery system.
• Collaborate with teammates and Management to meet department goals and objectives.
• Provide guidance and first-line support for Eligibility situations when the manager is absent.
• Host training classes for newly hired departmental employees and assist with their learning process.
• Build relationships across multiple clinic locations while supporting consistent Eligibility operations.
• Participate in performance improvement activities, audits, safety education, and department projects.

This position is a great fit for someone who brings accountability, patience, and a genuine passion for helping people. You’ll have the opportunity to guide colleagues, strengthen department processes, and make a direct impact on patients’ ability to receive timely care. By remaining calm under pressure and working closely with others, you’ll help both patients and teammates feel supported and prepared.

• Make a daily difference in the lives of patients and families.
• Grow your leadership skills through training, coordination, and first-line departmental support.
• Contribute to a collaborative team environment centered on respect and service.
• Support the important connection between eligibility operations, accurate reimbursement, and healthcare access.

• →Conduct eligibility for clients following procedures and guidelines specific to each program.
• →Confirm any additional client’s payer source such as Medicaid, Medicare, ADAP, and any other third party insurance.
• →Register clients into the CPCDMS and manage record owner transfers when and if needed.
• →Complete all necessary paperwork and perform data entry for eligible clients into the electronic system.
• →Maintain up-to-date and orderly eligibility files.
• →Conduct renewal eligibility as required by each program.
• →Confirm eligibility appointments with clients and set initial service appointments once eligibility has been determined.
• →Provide clients with a list of required eligibility documentation.
• →Assist clients with Marketplace.
• →Participate in the Performance Improvement Program.
• →Demonstrate respect for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment.
• →Serve as the first-line contact in the manager’s absence regarding Eligibility situations.
• →Monitor multiple clinic schedules on a daily basis.
• →Complete site visits to multiple clinic locations to manage and assist the Eligibility Department when needed.
• →Participate in external, internal, quarterly, and yearly audits.
• →Host newly hired departmental employees’ Training Class and assist with the learning process.
• →Assist Management with multiple reports based on program-specific needs.
• →Assist with other projects, as needed.
• →Promote effective working relationships and work effectively as part of a team to facilitate the department’s ability to meet its goals and objectives.
• →Attend all required safety training programs and describe responsibilities related to general safety, department/service safety, and specific job-related hazards.
• →Attend all required safety education programs.
• →Operate assigned equipment and perform all procedures in a safe manner as instructed.
• →Maintain work areas and equipment in the condition required by Legacy standards.
• →Demonstrate proper body mechanics in all functions.
• →Check the patient’s environment and equipment to ensure safety.
• →Report safety concerns promptly to appropriate personnel.
• →Follow Legacy’s exposure control plans for bloodborne and airborne pathogens.
• →Demonstrate knowledge of techniques, procedures, and correct use of protective barrier equipment, including Universal Precautions.
• →Assure a safe environment by instituting appropriate control measures.
• →Attend annual education programs.
• →Perform other duties as assigned.

• High School Diploma or GED, some medical knowledge

• A minimum of 3-5 years of medical billing experience

• Some training or background in ICD-A / CPT codes preferred

• Bilingual required
• Ability to understand and practice bookkeeping and accounting terminology required.
• Knowledge of medical terminology and billing practices preferred.
• Ability to operate computers and other office machines required.
• Must be able to take responsibility and work under pressure

Approachable & Collaborative — Leads with humility, values diverse perspectives, and builds trust through teamwork.

Driven & Committed — Takes initiative and goes the extra mile to improve patient outcomes and drive continuous improvement.

Thoughtful Communicators — Pairs clinical/technical skill with emotional intelligence, navigating complex situations with empathy and professionalism.