Under close supervision, interview/screen, referred patients to determine eligibility for alternate health resources. Assist the patient with successful completion of applying for eligible programs; Medicaid, Medicare, VA Health Benefits, or Federally Facilitated Marketplace enrollment.
The following duties are intended to provide a representative summary of the major duties and responsibilities and ARE NOT intended to serve as a comprehensive list of all duties performed by all employees in this classification. Incumbent(s) may not be required to perform all duties listed and may be required to perform additional, position-specific duties.
REPRESENTATIVE DUTIES
Assist patient and families in application process by conducting interviews, over the phone or in person, to determine eligibility for alternate health resources (Medicaid, Medicare, Private insurance, Veterans Administration, Tribally Sponsored Health Insurance Program etc.)
Customer service experience; must be able to communicate effectively with patients and families to provide updates on application information and required documents needed to present to state department.
Ability to work with patients who may be terminally ill, homeless, or require special assistance.
Work collaboratively with other members of the team/department, as well as outside agencies, to ensure a standard of customer services and professionalism. Must be able to work with and be a productive member of a team.
Ensures accuracy of electronic health records and other database systems to assure accurate processing of information for tracking and reporting.
Maintain patient records and confidentiality.
Performs other duties as assigned or required.
Required Skills
Required Experience
MINIMUM EDUCATION QUALIFICATION
A high school diploma or GED equivalent.
MINIMUM EXPERIENCE QUALIFICATION
Health Benefits Specialist I
Non-supervisory – One (1) year of experience, within the last 12 months, working in a medical office setting
performing data entry, quality customer service, in-person and on-phone customer interactions, email
correspondence with members of the team and other members of the organization as well as outside
agencies. Must be capable of mastering outpatient screenings for referred patients.
Health Benefits Specialist II
Non-supervisory – Must have 2 years experience, working in a medical office setting performing data entry,
quality customer service, in-person and on-phone customer interactions, and email correspondence with
members of the team and other members of the organization as well as outside agencies.
AND
Must have successfully mastered Two (2) of the following areas of HBS duties:
Inpatient screening
Outpatient screening
Purchased referred care screening and enrollment
Tribally-Sponsored Health Insurance Program (TSHIP)
Health Benefits Specialist III
Non-supervisory – Must have 3 years experience, working in a medical office setting performing data entry,
quality customer service, in-person and on-phone customer interactions, email correspondence with
members of the team and other members of the organization as well as outside agencies, and knowledge
of community resources.
AND
Must have successfully mastered all Four (4) areas of HBS duties:
Inpatient screening
Outpatient screening
Purchased referred care screening and enrollment
Tribally-Sponsored Health Insurance Program (TSHIP)
The following demands are representative of those that must be met by an employee to successfully
perform the essential functions of this job:
may be present.
This job description is not an employment agreement or contract. Management has the exclusive right to
alter this job description at any time without notice.
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