Patient Benefits Specialist- ACCESS Genesis
About The Position
The Patient Benefits Specialist (PBS) works directly with patients to explain insurance coverage, financial responsibilities, and payment options. The role supports ACCESS’ reimbursement through accurate benefit assessments and patient guidance. It also conducts screening and intake to help determine eligibility for healthcare programs, grants, and coverage options. As part of the patient care team, the PBS helps patients navigate the revenue cycle and access appropriate financial resources while supporting a seamless care experience. The position works regularly in a standard office environment and occasionally in a health center setting. Local travel between health centers and community events is required, and reliable transportation is necessary.
Requirements
- High school diploma or GED.
- At least two years of customer service experience.
- Intermediate proficiency with Microsoft Office products, such as Word, Excel, and Outlook.
- Ability to communicate clearly and effectively with diverse patients.
- Strong organizational and multitasking skills.
- Reliable transportation for required local travel between health centers and community events.
Nice To Haves
- Prior experience with All Kids and Moms & Babies (MPE) programs.
- Knowledge of Medicare, Medicaid, Marketplace insurance, and HMO regulations.
- Knowledge of Electronic Health Records (EHR), especially EPIC.
- Bilingual in English and Spanish.
Responsibilities
- Conduct benefit orientations, explain financial requirements and patient responsibilities, and obtain required forms, documents, and signatures.
- Conduct financial assessment interviews to screen patients for healthcare benefits, insurance coverage, and eligibility for grants or assistance programs; explain available options to patients and their families.
- Verify patients’ third-party and other healthcare coverage, identify coverage gaps, and explain insurance options.
- Assist patients and families with program enrollment based on financial assessment and selected options.
- Enter and update benefit-coverage information in the EHR; scan and upload required forms and documentation accurately and in compliance with organizational and regulatory standards.
- Maintain current knowledge of Medicare, Medicaid, Marketplace and private insurance, HMO, and Sliding Fee Scale rules and regulations.
- Assist patients with Medicaid applications and follow up annually for redetermination.
- Coordinate patient care with providers, medical assistants, and other employees using a team-based approach; advocate for patients and families.
- Help patients navigate the revenue cycle, provide support and guidance within the role’s scope, and make a warm hand-off to the appropriate party when needed.
- Maintain patient confidentiality and HIPAA standards.
- Work with irate callers and patients to identify and address concerns.
- Perform other duties as assigned.
Benefits
- Tuition reimbursement and student loan forgiveness programs for qualifying individuals.
- Comprehensive healthcare coverage, including medical, dental, and vision.
- Generous paid time off (PTO).
- 403(B) retirement plan and financial resources to help employees save and plan for retirement.
- Life insurance.
- Opportunity to participate in cross-departmental committees focused on innovating and transforming care delivery and the workplace.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
