Benefits Counselor

Community Behavioral Health.•Somerset, NJ

About The Position

The Benefits Counselor will be knowledgeable about eligibility requirements and the benefit packages associated with health insurance coverage options available to Health Center patients. The Benefits Counselor will facilitate the assessment and subsequent enrollment of eligible uninsured patients. This position will be expected to maintain daily logs, complete and submit reports on contacts, applications submitted, and outcomes. The Benefits Counselor will be responsible for filling in at other AHS health centers as volume or extended absence of other staff dictates.

Requirements

High School Diploma required.
Excellent written and verbal skills (English). Second Language is a plus.
Skilled in Microsoft Word and Excel. Experience with electronic health records a plus.
Must have an original, current, valid and acceptable PA Child Abuse History Clearance, or obtain one within (2) months of hire.
Must have valid driver’s license and automobile or access to public transit as the job requires local travel (attendance at quarterly meetings, staff trainings, and Health Center coverage as needed etc.).

Nice To Haves

Some college or Bachelor’s Degree preferred.
Prior knowledge of health insurance preferred. Experience working in public sector preferred.
Experience with electronic health records a plus.

Responsibilities

Explain the benefits and eligibility standards for relevant insurance programs to Health Center patients, with a focus on Medical Assistance and the Children’s Health Insurance Program (CHIP). Will require basic knowledge of Affordable Care Act program eligibility.
Determine appropriate insurance program for the patient.
Refer patients who qualify for Affordable Care Act coverage through the Health Insurance Marketplace to Insurance Specialist or Health Federation Navigator for assistance.
Submit MA/CHIP enrollment forms via COMPASS to appropriate office/agency for processing on behalf of patients, ensuring inclusion of all necessary documentation, and follow-up with client and office/agency as needed.
Work with insurance programs and staff to ensure proper and complete processing of application(s).
Assist patients who are denied benefits with the appeal process as needed.
Maintain accurate and complete logs, files and statistics of contacts, application statuses, and reasons for denial.
Work closely with Health Center medical, nursing, and social work staff to assist patients in receipt of insurance benefits.
Assist patients with other insurance-related tasks including HMO and PCP selections or changes, benefits questions, etc.
Use Health Center electronic medical records to ensure thorough communication of patient’s eligibility and application status.
May collaborate with PCCY, CLS and other community agencies in efforts to increase enrollment of health center patients.