Our Core Values

The culture at Prism Health North Texas is built on our shared Core Values. We make hiring, firing, promotion and performance review decisions based on these values and behaviors, so it is important that you also share these Core Values:

• We are solution seekers. The organization’s founders found solutions even during the AIDS crisis of the 80’s; we remain proactive, thrive on change, and always willing to take the lead.
• We have a can-do attitude. We are flexible, agile, and never say, “It’s not my job.” We always seek growth, and we are never late but always willing to stay late to see the last patient.
• We are mission driven. We are committed to health equity; recognize all contributions are meaningful and valued. It is never about the me or I, but about the we.
• We care about people. We celebrate diversity, equity, and inclusion; we are kind and practice acts of kindness, all in service to our patients and each other.

General Description:
The Healthcare Benefits Navigator is committed to the provision of patient centered care. This position directs clients to needed core medical or support services in person or through telephone, written, or other type of communication. This service may include referrals to assist eligible clients to obtain access to other public or private programs for which they may be eligible (e.g., Medicaid, Medicare Part D, State Pharmacy Assistance Programs, Pharmaceutical Manufacturer’s Patient Assistance Programs, and other state or local health care and supportive services, or health insurance Marketplace plans).

Job Responsibilities

Specific Responsibilities of the Job:

• Manages the ADAP enrollment program process and ensures annual recertification's are completed by the last day of the patient’s birth month and that six month recertification's are completed by the last day of the patients half birth month.
• Advises and educates patients regarding registration process, financial assistance programs, including facilitating a patient’s access to public/private health and disability benefits and programs such as:
• Health Insurance Plans/Payment Options (CARE/HIPP, COBRA, OBRA, Health Insurance Assistance (HIA), Medicaid, Medicare, Private, ACA/Marketplace)
• SNAP
• Pharmaceutical Patient Assistance Programs (PAPS)
• Social Security Programs (SSI, SSDI, SDI)
• Temporary Aid to Needy Families (TANF)
• Veteran's Administration Benefits (VA)
• Women, Infants and Children (WIC)
• Other public/private benefits programs
• Manages patient’s health record to ensure that all required information is correct and complete in the Prism Health North Texas (PHNTX) system and information is available to perform pre-registration, and on an ongoing basis to ensure continued eligibility.
• Maintains and implements knowledge of the rules, regulations, policies, procedures, guidelines, laws; i.e. Medicaid, Medicare, Medicare Part D, Texas Department of Insurance, Dallas County Health & Human Services, Texas Department of State Health Services, etc. that impact or govern eligibility services and ensures that clinic operations are in compliance.
• Stays abreast of the latest developments, advancements, and trends in business services by attending seminars/workshops, reading professional journals and/or actively participating in professional organizations and integrates this knowledge as appropriate into the job.
• Establishes and cultivates a positive working relationship with management, vendors, other hospitals, employees, federal, state and local agencies, etc. to ensure that positive working relationships are maximized and maintained for optimal services to be provided to internal and external customers of PHNTX and its clinics.
• Identifies ways to improve work processes and procedures or methods and make recommendations to the clinic administrator or clinic manager for appropriate changes to improve effectiveness, productivity, efficiency, and customer satisfaction that support the overall goals of the Agency.
• Other duties as assigned.

Direct Reports:
None

Required Skills and Qualifications

Required Knowledge, Skills and Abilities:
Job Requirements:

• Must have excellent customer service skills and high level of professionalism.
• Must have strong sense of professional boundaries and communication skills.
• Must be experienced with Excel, Word, and Outlook and data entry.
• Must be able to handle multiple, ongoing tasks with minimum supervision.
• Must be able to coordinate effectively between multiple departments.
• Must be able to work with all types of people.
• Must be able to lift 25 pounds.

Education and Experience:

• Minimum of high school diploma or G.E.D.
• Must have 2 years’ experience in eligibility determination.
• Bilingual preferred