Benefit Coordinator-US BASED APPLICANTS ONLY; NO SPONSORSHIP AVAILABLE

Warm Valley Health Care•Fort Washakie, WY

13d

About The Position

GENERAL STATEMENT: Responsible for obtaining insurance pre-authorizations, assisting patients with obtaining and maintaining health insurance coverage, submitting insurance claims, and following up on account receivables. DUTIES AND RESPONSIBILITIES: Assist patients with the process of obtaining and maintaining maximum insurance coverage, including identifying available health care insurance options as needed. Remain current on available insurance options, including eligibility and enrollment requirements. Screen new patients' referrals for insurance coverage, obtain any necessary pre- authorization, and provide timely approval for admission. Work closely with members of the patient's care team to address any barriers to maintaining insurance coverage. Enter and maintain insurance coverage and related demographic information in RPMS. Monitor the status of applications for patients applying for Medicaid/Medicare with the PRC. Assist with applications for additional programs offered to patients. Work closely with community and governmental agencies, including Social Security and Medicare and private insurance companies to assist patients in resolving insurance eligibility. Bring to the attention of the Billing department any insurance or coverage issues. Reports weekly status/workload to Supervisor. Reach out to patients regarding additional information required for Medicaid/Medicare/VA eligibility. Entered detailed records in the RPMS as to the status of patient application/eligibility. Participate in organizational process improvement meetings. Works closely with Patient Registration, PRC, Nursing, and specialty clinics to identify and assist patients with any alternate resource patient may qualify for. Performs continuous research and updating information involving changes in rules and regulation for alternate resources. Other duties and/or tasks that may be assigned on an as-needed basis.

Requirements

Two years of related experience, required
Knowledge of eligibility requirements for Medicare, Medicaid, and SSI to assist patients in seeking benefits
Working knowledge of various third-party resources, established procedures and how they benefit the patient/clinic and how it relates to the Business Office/PRC
Ability to work with the public and provide positive customer service
Ability to keep abreast of current changes in regulations and policies on alternate resources eligibility, Business Office and Purchase Referred Care program regulations
The ability to interview patients in order to determine eligibility for alternate resources
Communication skills are required to effectively explain and solicit appropriate information from the patient
The ability and skill to compile and write reports from various documents maintained in the Business Office
Must pass pre-employment drug screening
Successfully pass the employment background check

Responsibilities

Assist patients with the process of obtaining and maintaining maximum insurance coverage
Remain current on available insurance options
Screen new patients' referrals for insurance coverage
Work closely with members of the patient's care team to address any barriers to maintaining insurance coverage
Enter and maintain insurance coverage and related demographic information in RPMS
Monitor the status of applications for patients applying for Medicaid/Medicare with the PRC
Assist with applications for additional programs offered to patients
Work closely with community and governmental agencies to assist patients in resolving insurance eligibility
Bring to the attention of the Billing department any insurance or coverage issues
Reports weekly status/workload to Supervisor
Reach out to patients regarding additional information required for Medicaid/Medicare/VA eligibility
Entered detailed records in the RPMS as to the status of patient application/eligibility
Participate in organizational process improvement meetings
Works closely with Patient Registration, PRC, Nursing, and specialty clinics to identify and assist patients with any alternate resource patient may qualify for
Performs continuous research and updating information involving changes in rules and regulation for alternate resources
Other duties and/or tasks that may be assigned on an as-needed basis