Patient Benefits Coordinator

Seldovia Village Tribe IRA•Kachemak City, AK

2d•$22 - $25•Hybrid

About The Position

As part of the Revenue cycle team, Patient Benefits Coordinators screen and verify third party eligibility to maximize reimbursement and facilitate revenue cycle improvement. They implement, organize and facilitate all aspects of third-party enrollment assistance to individuals and families. Patient Benefits Coordinators participate in public events to educate and share information on financial healthcare resources, coordination of benefits, and to assist with enrollments.

Requirements

High School Diploma or equivalent required.
Three year’s experience working with the public in an office setting; or equivalent combination of education and experience.
One year experience with Medicaid, Medicare and commercial insurances directly.
Familiarity with federal, state, and local resources available to meet the health and social needs of patients.
Knowledge of medical billing procedures and medical terminology.
Knowledge of HIPAA, and other state and federal regulations governing healthcare practices.
Skill in working independently and as a team member.
Skill in establishing and maintaining cooperative working relationships with others.
Ability to work with patients who are in distress and problem solve in a calm, professional manner.
Strong computer and communication skills are a must.
Strong attention to detail and concern for completing tasks correctly and efficiently.
Ability to prioritize responsibilities according to urgency and importance.
Maintains a professional positive attitude at all times.
Proficient in medical terminology.
Adhere to HIPAA regulations as outlined in SVTHW policy and procedure, state and federal regulations to protect and maintain personal health information.
Proficiency in Microsoft Office (Word, Excel, PowerPoint) and Outlook.
Proficiency with scheduling / insurance verification software.
FBI Fingerprinting
Pre-employment Drug Testing
Pre-employment Background Screening

Nice To Haves

Associates degree preferred.
Certified Medicare Counselor (State of Alaska)
Health insurance Marketplace – Certified Application Counselor
Tribal Veteran Representative (TVA)
AAHAM Revenue Cycle Specialist Certification

Responsibilities

Verifying and documenting current patient eligibility and benefits with third-party payers prior to the patient visit.
Monitoring daily schedule to verify benefits and eligibility for any patients seen on the same-day.
Working with the Revenue Cycle team and patients to ensure communication on payment expectations at time of service (i.e. co-pays due, more information needed).
Providing problem-solving assistance to Revenue Cycle Team regarding billing for all patients where billing problems are identified in the verification process, and through appeal efforts for authorization-related denials.
Performing and documenting Discount Fee Program income verification checks as required by current policy and procedure.
Determining patient eligibility for prescription “340B” program, issuing cards, maintaining Care Card database and tracking.
Assisting patients as requested by medical team in applying for manufacturer Prescription Assistance Programs (aka PAPA).
Monitoring for Worker’s Compensation-related appointments to ensure required billing information is in place.
Inputting Alaska Breast & Cervical Insurance for any Well Woman Exams while reviewing future appointments.
Providing insurance-related training and back-up support to Patient Service Representatives.
Coordinating SVT Purchased-Referred Care (PRC) application process and maintaining current PRC-eligible list in conjunction with designated PRC coordinator of SVT.
Coordinating Alaska Native Medical Center (ANMC) patient registration process and assuring that all Alaska Native/American Indian (AN/AI) patients/partners have registered and/or updated their demographics.
Meeting with individuals and families to assist with eligibility for, and enrollment into, the Healthcare Marketplace, Veteran’s Health Benefits, Medicare, Medicaid, and Children's Health Insurance program coverage options.
Providing information about enrollment options, interpreting standards and guidelines, answering questions, obtaining consent for services and offering assistance in a manner that is culturally and linguistically appropriate to diverse community residents and accessible to individuals with disabilities.
Actively collaborating with staff to identify uninsured patients and connect them with health care resources for which they may be eligible.
Documenting and maintaining a record of enrollment/eligibility encounters (application tracking system) with individuals and families.
Conducting follow-up on the progress of enrollment and helping troubleshoot enrollment barriers.
Tracking the number of eligibility assistance provided and successful enrollments in the Healthcare Marketplace, Veteran’s Health Benefits, Medicare, Medicaid, and other plans.
Completing and submitting quarterly Tribal Medicaid Administrative Claiming (TMAC) reports.
Maintaining current knowledge of local, regional, state and national resources.
Completing required federal and/or state consumer assistance training to provide fair, accurate and impartial assistance.
Providing new employee onboarding training regarding the Health Insurance Marketplace, Medicaid, Denali KidCare and Veteran’s Health benefits.
Developing materials, disseminating, and collaborating with the local community to provide education on the importance of health care coverage and addressing barriers to enrollment at community events.
Other duties as assigned.