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Eligibility Specialist - Montrose Clinic

Legacy Community Health is a premium, Federally Qualified Health Center (FQHC) that provides comprehensive care to community members regardless of their ability to pay. Our goal is to treat the entire patient while improving their overall wellness and quality of life, in addition to providing free pregnancy tests, HIV/AIDS screening. At Legacy, we empower patients to lead better lives by promoting healthy behaviors and offering resources such as literacy classes, family planning services, and nutrition and weight management information.

Our roots began in 1981 as the Montrose Clinic, with specialization in HIV education, testing, and treatment. Since then, the agency has expanded to >50 clinics in Houston, one in Baytown, two in Beaumont, and one in Deer Park with extensive services that include: Adult primary care, HIV/AIDS care, pediatrics, OB/GYN and maternity, dental, vision and behavioral health. We also service students within KIPP and YES Prep schools. Legacy is committed to driving healthy change in our communities.

Job Description

The Eligibility Representative offers inbound and outbound phone support using telephony and EMR system(s). The ideal candidate has experience in a contact center environment and can understand the needs of others to meet those needs with great service and operational processing accuracy. Knowledge of the healthcare industry including clinical terminology, insurance, medical billing processes, and EMR systems preferred but not required. The ability to have premier service interactions with patients is critical to success in this role, in addition to processing with operational accuracy and excellence.

Essential Functions

  • Manage outbound phone calls in an empathetic and effective manner
  • Consistently process requests with the highest degree of operational accuracy
  • Deliver on a commitment to solve problems with patience and understanding, providing knowledgeable and thoughtful service
  • Schedule appointments and demonstrate active listening to identify and analyze client problems, providing information and solutions in a timely manner
  • Communicate effectively, including appointment details, insurance information, and medical questions via telephone, email, and chat
  • Ensure that all barriers to care (such as language, transportation restrictions, or financial needs) are addressed
  • Collect and update new patient's demographic and insurance information
  • Provide clear, thorough, and accurate documentation of all interactions with patients, and other individuals on behalf of patients, in the patient's electronic health records
  • Follow organizational guidelines regarding the use of the Electronic Medical Record (EMR) in compliance with HIPAA and patient confidentiality standards
  • Maintain access to the Health Information Exchange (HIN) and other related systems
  • Use HIN and other related systems to gather information needed to coordinate care and keep patients' electronic health records up to date with the status of care that is being coordinated
  • Quickly and accurately complete any required data entry including patient demographics and payer information, call logging and/or reporting
  • Maintain surveillance ticklers and/or works with Health Information Technology to proactively identify the need for patient care
  • Navigate patient to care, as assigned

Required Education, Certifications, Licenses, & Training

  • High school diploma or GED

Required Years of Experience

  • 1-2 years minimum customer service experience
  • 1+ year of experience working in a fast paced environment
  • Excellent telephone etiquette
  • Bilingual English/Spanish required

Desirable Education and/or Experience

  • Medical Assistant experience or clinical office support experience highly preferred
  • Call center experience is highly preferred
  • Healthcare experience is preferred
  • EMR experience is a plus


As part of values that Healthcare is a Right and not a Privilege, we offer a suite of benefits 

  • Medical / Vision / Dental (Costs of benefits are based on your yearly salary)
    • Visits within the Legacy clinic are
  • 9 Holiday + 1 Floating Holiday
  • 403b Retirement Plan
  • Bright Horizons Back-up Care
    • As a user of Bright Horizons Back-Up Care, you can conveniently schedule care right from your mobile device with the Back-Up Care app– your easy, time-saving solution to managing family care challenges while on the go.
  • Paid Time Off (PTO)
    • PTO Exchange benefit

PTO Exchange will provide you with the option to convert a portion of your accrued but unused PTO hours for use toward several different benefits and causes, based on your own priorities.

With PTO Exchange, you can convert a portion of your unused PTO into:

  • 403(b) Retirement contributions
  • Student loan payments / Tuition for the employee
  • Leave Sharing donations to fellow employees

If you would like to APPLY, please use the link below:

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