Patient Benefit Advisor I - Patient Business Services

POSITION SUMMARY
The Patient Benefit Advisor I will be responsible for providing a comprehensive, accurate, timely review of medical benefit information to patients during their inpatient hospitalization. This will include the presentation of a service estimate and collection of patient responsibility where applicable.

PRIMARY ACCOUNTABILITIES

• Understanding of payer websites information and vendor applicable systems information to verify and analyze appropriate coverage information and patient responsibility information.
• Produce and review a service estimate based on department guidelines with each patient.
• Obtain accurate information from patient/family in a pleasant, efficient manner.
• Ability to professionally and compassionately review and explain insurance benefits, and ask for and collect patient responsibility from patient.
• Maintain established quality assurance and productivity benchmarks while utilizing best practice standards established.
• When appropriate, recommend financial assistance to include any and all programs available to the patient to assist with bill payment.
• Process all referrals in timeframe established by department.
• Update account in all systems to accurately reflect patient information using appropriate note codes.
• Ability to apply logic and common sense to identify issues related to work performed.
• Ensure compliance with state and federal laws regarding all aspects of role.

MINIMUM QUALIFICATIONS

• Education: High School Graduate or equivalent.
• Licensure: None Required
• Certification: None Required
• Work Experience in Related Field: Six months customer service experience.
• Work Experience in Lieu of Degree: NA
• Knowledge/Skills/Abilities:
  • Working knowledge of Microsoft Office – Outlook, Word, Excel.
  • Ability to work autonomously with minimal supervision.
  • Foundational critical thinking skills.
  • Strong communication skills and professional presence.
  • Ability to maintain composure in stressful work environment.
  • Excellent communications/interpersonal skills.
  • Ability to prioritize and organize to maximize quality, value and service.
  • Ability to adapt to a potentially rapid changing environment or work process.
  • Excellent teamwork and collaboration skills.

PREFERRED QUALIFICATIONS

• Education: Associates degree or higher in related area
• Licensure: None
• Certification: None
• Work Experience in Related Field: One plus year’s customer service experience
• Work Experience in Lieu of Degree: NA
• Knowledge/Skills/Abilities:
  • Medical Benefit Terminology
  • Strong critical thinking skills
  • Experience working in multiple computer systems simultaneously
  • Strong organizational skills

PHYSICAL REQUIREMENTS

• Sedentary work involves sitting most of the time.
• Walking and standing or lifting more than 10 pounds are required only occasionally.
• Must be able to tolerate long periods of computer time a day.
• Must be able to tolerate long periods of phone time a day.
• Ability to enter information using hand/wrist dexterity.
• Visual acuity and hand eye coordination to preform various tasks.

ABOUT HEALTH FIRST

At Health First, diversity and inclusion are essential for our continued growth and evolution. Working together, we strive to build and nurture a culture that recognizes, encourages, and respects the diverse voices of our associates. We know through experience that different ideas, perspectives, and backgrounds create a stronger and more collaborative work environment that delivers better results. As an organization, it fuels our innovation and connects us closer to our associates, customers, and the communities we serve.