Sr. Clinic Eligibility Coordinator (DHWC)

Role Overview & Responsibilities 

Position Summary

The Sr. Eligibility Coordinator serves as a key ambassador for patient experience within the Clinic Eligibility Department, ensuring a welcoming and professional environment while managing high patient volumes and shifting priorities. Responsibilities include conducting daily high-volume eligibility inbound call screenings related to program eligibility, in person eligibility interviews, verifying financial and insurance information, and coordinating access to medical, dental, and behavioral health services providing high-quality patient-centered customer service. 

This role is responsible for assisting established patients with inquiries related to registration, appointments, and general services, while also screening prospective patients and clients for eligibility across medical, dental, and case management programs for Methodist Healthcare Ministries (MHM).

 The position requires strong leadership, organizational skills, and the ability to troubleshoot and support team members in real time, while maintaining accurate health records, training staff, and serving as a point of contact in the absence of leadership.

Scope and Impact

This role requires the ability to work maintain professionalism and composed demeanor while being responsible for high volume of incoming phone calls and in-person eligibility interviews. The ideal candidate communicates effectively in alignment with MHM core values. Demonstrates strong critical thinking skills and delivers an exceptional patient experience.

This role has a direct and meaningful impact on the overall patient experience within the Clinic Eligibility department. By ensuring a welcoming and professional environment, the position influences patient satisfaction and directly demonstrates MHM’s core values by providing high-quality care. The role is critical in managing access to medical, dental, and behavioral health services, as well as connecting patients to external community resources, which supports equitable access to care for underserved populations. 

Decision-Making Authority

This position requires analytical decision-making in evaluating patient eligibility and resolving intake-related issues. Works under established guidelines but exercises discretion when resolving patient/client/applicant eligibility concerns. Delegates task to clinic eligibility coordinators and is the acting point of contact when Clinic Eligibility Leadership is not available. 

Interactions / Working Relationships

 

Essential Duties and Responsibilities

• Conduct clinic eligibility screenings and interviews through high-volume inbound and in-person eligibility interviews for medical, dental, and behavioral health services.
• Obtains and evaluates required clinic eligibility documentation in accordance with MHM guidelines to determine program eligibility. 
• Apply critical thinking and sound judgment to evaluate patient/client/applicant needs and identify appropriate next steps for care and services.
• Communicate eligibility requirements, eligibility determination and sliding-fee program discount if applicable professionally to patients/clients/applicants.
• Schedules and coordinates patient/client/applicant appointments.
• Assist patients with completing financial assistance applications, including Methodist Healthcare System Financial Assistance Program applications.
• Review and process financial assistance documentation for completeness and accuracy.
• Utilize department platforms, databases, and systems to support financial screenings and eligibility determinations.
• Ensure eligibility determinations comply with applicable state and federal regulations and organizational policies.
• Maintain accurate documentation to support eligibility determinations and patient account management.
• Demonstrate strong attention to detail and accuracy when reviewing financial and eligibility information.
• Apply AIDET communication standards to promote positive patient experience.
• Conducts follow-up communication with patients and clients as needed.
• Educate patients on available organizational services and resources.
• Professionally manage and resolve patient concerns, questions, and inquiries using effective problem-solving and critical thinking skills. 
• Demonstrate strong verbal and written communication skills in interactions with patients, clients, and internal teams.
• Maintain accurate and confidential patient records within Electronic Health Record (EHR) systems in compliance with HIPAA and organizational policies.

• Monitor patient/client wait times and call queues to promote timely service and minimize delays.
• Maintain an organized and professional workspace to support operational efficiency.
• Work independently with limited supervision while maintaining established productivity and performance standards.
• Meet or exceed department productivity, quality, and performance metrics.
• Identify and resolve routine operational issues using effective problem-solving skills.
• Demonstrate strong organizational skills, attention to detail, and the ability to manage multiple priorities in a fast-paced environment.
• Perform additional administrative and operational duties as assigned.

Supervisory or Leadership Responsibilities

This position does not supervise others.

 

Qualifications

Minimum Qualifications (Required) 

 

Preferred Qualifications

 

Knowledge, Skills, and Abilities (KSAs)

 

Language Skills

Technology and Tools

Work Environment and Physical Demands