Health Benefits Specialist I, II - $1,000 Sign-On
About The Position
The Health Benefits Specialist I, II plays a critical role in supporting the administration and management of health benefit programs within the healthcare and social assistance sector. This position is responsible for ensuring that eligible individuals receive accurate information and timely access to their health benefits, contributing to overall employee satisfaction and well-being. The specialist will collaborate with internal teams and external vendors to resolve benefit-related inquiries, process claims, and maintain compliance with regulatory requirements. By analyzing benefit plans and assisting with enrollment processes, the role helps optimize the delivery and utilization of health benefits. Ultimately, this position ensures that health benefits are effectively communicated and administered, supporting the organization's commitment to quality care and employee support. This position will be supervised by the Manager of Outreach & Enrollment.
Requirements
- High school diploma or equivalent; Associate’s degree or higher preferred.
- Three (3) years prior experience performing administrative and customer service duties.
- One-year (1) experience performing duties in scheduling, registration, health information management, coding, and/or billing.
- Experience in benefits administration, customer service, or a related field within healthcare or social assistance.
- Basic knowledge of health insurance plans, terminology, and claims processing.
- Proficiency with computer systems and software applications relevant to benefits administration.
- Strong communication skills to effectively interact with employees, vendors, and internal teams.
Nice To Haves
- Bachelor’s degree in healthcare administration, human resources, or a related discipline.
- Certified Application Counselor (CAC) or obtain CAC within six (6) months of hire.
- Two (2) years of experience as a Level I Specialist; or demonstrated proficiency.
- Experience working with health insurance carriers and third-party administrators.
- Familiarity with federal and state regulations governing health benefits, such as HIPAA and ACA.
- Advanced skills in data analysis and reporting tools to support benefits program evaluation.
Responsibilities
- Assists patients with inquiries related to health benefit plans, coverage details, and claims processing.
- Process enrollment, changes, and terminations in health benefit programs accurately and within established timelines.
- Collaborate with insurance carriers, third-party administrators, and internal departments to resolve benefit issues and discrepancies.
- Maintain up-to-date knowledge of health benefit policies, regulations, and compliance requirements to ensure accurate information dissemination.
- Prepare and maintain detailed records and reports related to health benefits administration and utilization.
- Support open enrollment activities by providing guidance and educational materials to patients.
- Identify opportunities for process improvements to enhance the efficiency and effectiveness of health benefits administration.
- Screens and interviews patients to determine eligibility for alternate health resources (AHR) such as Medicaid, Denali Kid Care, Medicare, VA, Tribally Sponsored Health Insurance (TSHIP), HRSA/Sliding Fee discounts, or other health programs.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
101-250 employees
