HIP Client Service Coordinator

JOB PURPOSE:

The Health Insurance Program (HIP) Client Services Coordinator functions under the supervision and guidance of the HIP Assistant Director. The Health Insurance Program (HIP) Client Services Coordinator provides direct client-facing support for individuals enrolled in or applying to the Health Insurance Program. This position is responsible for assisting clients with applications and recertifications, verifying insurance information, retrieving missing documentation such as EOBs, conducting follow-up communications, and ensuring that claims and eligibility information are complete before processing. The role requires professionalism, accuracy, strong interpersonal skills, and the ability to maintain confidentiality while delivering a high level of client service and program support.

Essential Job Functions include, but are not limited to:

1. Satisfies Core Competencies
   • Accepts responsibility for meeting the standards of the professional, ethical, and relevant legislated requirements.
   • Maintains a strong commitment to quality, client confidentiality, and compliance with federal and state health information privacy laws (HIPAA).
2. Eligibility and Data Management: 
   • Process add/change forms and churn notices upon approval from LAHAP.
   • Research and review daily Ramsell reports and work collaboratively with HIP team members to address assigned tasks.
   • Identify, document, and report discrepancies to LAHAP in a timely manner.
   • Follow up with clients who have not recertified or who are nearing recertification deadlines.
3. Claims and Documentation Support:
   • Review claims using available reports and documentation to ensure accuracy and prevent duplication.
   • Verify client eligibility for dates of service through Ramsell or other approved systems.
   • Contact providers to obtain missing Explanation of Benefits (EOBs) or supporting documentation before claims are denied.
   • Match EOBs to claims to verify correct client cost-share amounts.
   • Forward ineligible claims to data entry for tracking and issuance of denial letters to providers, clients, and/or case managers.
4. Client Interaction and Case Support:
   • Meet with clients to assist with completing HIP and LAHAP applications and gathering required documentation.
   • Open support tickets to research, track, and resolve client concerns or inquiries.
   • Communicate timely updates, clarify issues, and ensure resolution of client questions.
   • Close tickets once inquiries are fully addressed.
   • Respond promptly and professionally to client and provider inquiries via phone, email, or in person.
   • Assist in obtaining premium invoices or other insurance-related documents as needed.
5. Safety/Infection Control:
   • Adhere to departmental policies, procedures, and objectives.
   • Maintain accurate communication and thorough documentation of client interactions and program activities.
   • Participate in required meetings, trainings, and program development activities.
   • Perform related tasks or special projects as assigned by the HIP Assistant Director.
6. Workforce Development: 
   • Responsible for maintaining up-to-date knowledge, skills, and abilities
   • Attends and participates in in-service, monthly staff meetings, continuing education offerings, community training events, conferences, and webinars as appropriate

Required Education:

High school diploma or equivalent required.

Associate degree in healthcare administration, human services, business administration, or related field preferred.

Experience in health insurance support, client services, medical office administration, or benefits coordination strongly preferred.

Equivalent combinations of education and experience may be considered.

Skills, Licensure, and Knowledge Requirements

Knowledge of health insurance processes, EOBs, eligibility, and enrollment preferred.

Strong customer service, communication, and interpersonal skills.

Ability to work compassionately and professionally with diverse populations.

Strong organizational, time-management, and problem-solving skills.

Proficiency in Microsoft Office (Word, Excel, Outlook) and data entry systems.

Ability to manage confidential information in compliance with HIPAA.

High attention to detail with the ability to identify inconsistencies or missing information.

Ability to multitask in a fast-paced environment while maintaining accuracy.

Physical Demands: 

The physical demands described here are representative of those that must be met by the employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

• While performing the duties of this job, the employee is regularly required to stand, sit, talk, hear, and use hands and fingers to operate a computer and telephone keyboard reach.
• Specific vision abilities required by this job include close vision requirements due to computer work.
• Light to moderate lifting is required.

Work Environment: 

The work environment characteristics described here are representative of those the employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Moderate noise (i.e. business office with computers, phone, and printers, light traffic).
• Ability to work in a confined area.
• Ability to sit at a computer terminal for an extended period of time.

Travel or Special Requirements:

Driving during the workday, as well as local or out-of-state travel, may be required to perform job duties.

This job description includes the essential job functions and responsibilities of the job. I understand that it is not inclusive of every task inherent to the job. In addition, I understand that it may occasionally require assignment of tasks not specifically covered in this job description. Duties, responsibilities, and activities may change at any time with or without notice. I understand that I will comply with reasonable requests from my supervisor.