Patient Benefits Coordinator
About The Position
POSITION SUMMARY: Coordinates, researches, identifies, and reviews alternative resources for tribal members and their families seeking alternative health benefits plans. ESSENTIAL FUNCTIONS: Identifies uninsured individuals, screens to determine eligibility, and provides guidance and assistance with applying for third party coverage; Interprets Federal and State rules and regulations by following explicit guidelines in order to determine patient eligibility for various Tribal health programs; Coordinates with internal and external departments and agencies to identify individuals who may be eligible for alternate resources; Develops and implements effective screening, outreach and interviewing techniques to identify health insurance coverage status of individuals; Develops and maintains various databases and updates insurance data on RPMS; Communicates member insurance eligibility with Patient Care Coordinator and assists with processing PRC identification cards; Analyzes and evaluates services, coverage and options available through alternate resources to determine plans best meeting the individual’s needs; Serves as advocate to address issues and answer insurance questions related to their alternate resources; Adheres to policies and procedures related to the Health Insurance Portability and Accountability ACT (HIPAA) and Health Information Technology for Economic and Clinical Health Act (HITECH); Maintains current knowledge of applicable federal and state privacy laws and conducts training to assure compliance within all levels of the organization; Communicates updates and/or changes to benefit programs; Prepares and submits monthly reports to the PRC Supervisor; Performs other position-related duties as assigned and required.
Requirements
- Associate degree; or three years’ related experience and/or training; or equivalent combination of education and experience.
- Must possess a valid Texas Driver’s License and be insurable.
- Must be bilingual – English/Spanish.
- Must be able to successfully pass a post-offer drug screen and criminal history background check.
- Knowledge on how to assist with the application process for alternate resources (Medicaid, Medicare, Health Exchanges, VA, etc.)
- Ability to understand and recognize appropriate program eligibility for families and individuals' health care needs
- Excellent written and oral communication skills.
- Ability to read, analyze and interpret professional journals, documents, governmental regulations, etc.
- Proficient in MS Office applications and database software.
- Ability to effectively present information and respond to questions from management and the public.
- Excellent interpersonal skills.
- Excellent customer service attributes.
- Must be able to effectively prioritize and manage multiple tasks.
- Must have excellent organizational and time management skills.
Responsibilities
- Identifies uninsured individuals, screens to determine eligibility, and provides guidance and assistance with applying for third party coverage
- Interprets Federal and State rules and regulations by following explicit guidelines in order to determine patient eligibility for various Tribal health programs
- Coordinates with internal and external departments and agencies to identify individuals who may be eligible for alternate resources
- Develops and implements effective screening, outreach and interviewing techniques to identify health insurance coverage status of individuals
- Develops and maintains various databases and updates insurance data on RPMS
- Communicates member insurance eligibility with Patient Care Coordinator and assists with processing PRC identification cards
- Analyzes and evaluates services, coverage and options available through alternate resources to determine plans best meeting the individual’s needs
- Serves as advocate to address issues and answer insurance questions related to their alternate resources
- Adheres to policies and procedures related to the Health Insurance Portability and Accountability ACT (HIPAA) and Health Information Technology for Economic and Clinical Health Act (HITECH)
- Maintains current knowledge of applicable federal and state privacy laws and conducts training to assure compliance within all levels of the organization
- Communicates updates and/or changes to benefit programs
- Prepares and submits monthly reports to the PRC Supervisor
- Performs other position-related duties as assigned and required.
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What This Job Offers
Job Type
Full-time
Education Level
Associate degree
