Patient Benefits Coordinator

Position Summary:

As part of our Patient Access Team, the Patient Benefits Coordinator’s day to day duties are to assist individuals and families identify, enroll, and access affordable health insurance options through Medicaid, Medicare and the Health Insurance Marketplace. Daily duties involve interviewing members to determine eligibility of alternate resources, assisting patients with the enrollment and renewal processes and following up with members about how to best utilize their benefits (medical and tribal). The position will also require filling in at the front desk of the Tribal Health Clinic; registering patients, answering phones, screening for insurance at registration, and performing daily operations when needed.

Essential Functions:

• Answer phone calls, take and triage phone messages
• Obtain eligibility information from patients seeking healthcare who have not previously been treated at th­e facility and document accordingly
• Understand internal and external agencies and resources that members may be eligible for; such as other tribal benefits, Health Insurance, VA, Food Share, Local and County Programs, etc.
• Assist the front desk with keeping all insurance information current for billing purposes
• Preform clerical functions such as typing, copying, faxing
• Mail out educational materials for uninsured and under insured and help determine whether they are eligible for alternate resources
• Identify individuals, screen for eligibility, and assist applicants in application processes for Medicaid, Badgercare, Private Insurance or enrollment through an employer plan or applicant’s Tribal plans when appropriate
• Excellent communication and deduction skills working with the Front Desk Staff, PRC office, and multiple internal and external departments so all offices can work together to ensure coverage
• Troubleshoot with and advocate for members by making phone calls and emails to outside agencies
• Demonstrates creativity in identifying appropriate service options and resources. Presents multiple solutions while helping the inquirer prioritize the most appropriate choices without creating unnecessary complexity. Provides clear, specific information about eligibility requirements and the application process for available services and resources.
• Help current and potential recipients understand the process, how to access their benefits and rights under federal law
• Independently advise on insurance trends and put together plans for goals for expanding access for patients and outreach
• Ensure record keeping and case management is done in a timely manner
• Follow OSHA and HIPAA guidelines
• Any other duties assigned by supervisor

Note: The essential functions are intended to describe the general contents of and requirements of this position and are not intended to an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by the incumbent’s immediate manager.

Directly Reporting to: Patient Access Manager

Matrix of INDIRECT Reporting: Health Division Head - St. Croix Tribal Council

Scope and Complexity:

Interacts with all levels of management and employees; often trusted with maintaining confidentiality and relaying highly sensitive messages, and appropriate application of business operations and practices.

Physical Demands/Environment Factors: OE-Typical Office Environment

• Requires extensive sitting with periodic standing and walking
• May be required to lift up to 50 pounds
• Requires significant use of computer, phone and general office equipment
• Needs adequate visual acuity, ability to grasp and handle objects
• Need ability to communicate effectively through reading, writing, and speaking in person or on the telephone
• May require off-site travel

Minimum Qualifications

• High School Diploma/GED
• Must demonstrate ability to assess customer and business needs and formulate plan of action; able to identify potential issues and proactively contain and manage challenges
• Requires intermediate level computer skills and ability to access information in meaningful ways
• Requires skill in conflict resolution and team building
• Must have demonstrated ability to work collaboratively with all levels of employees and managers
• Requires effective presentation, verbal and written communication skills
• Needs commitment to timelines and attention to detail for acceptable customer service

Preferred Qualifications

• Associates or Bachelor’s Degree in Social Work, Communication, or related field
• One or more years of experience is assisting individuals with Medicaid, Foodshare, Medicare, or other public assistance programs
• Ability to demonstrate comprehensive knowledge of federal, state, and local public benefit eligibility requirements and enrollment processes
• Strong customer service, communication, and problem-solving
• Proficiency in Microsoft office and electronic case management or health record systems (Nextgen, EHR Preferred)
• Commitment to providing compassionate, equitable, and person-centered service
• Demonstrates initiative by proactively identifying tasks, solving problems, and taking ownership of responsibilities
• Valid Drivers License
• Please Note: Candidate with preferred qualifications will be re-evaluated for wage scale, step and starting wage will reflect experience

Native American Preference Given in Accordance with P.L. 93-638 and Amendments

The offer is conditional based on confirmation that the candidate meets all specific criteria required (background check, driver’s insurability verification, references, identity verification, and other applicable requirements).

Pay: From $21.54 per hour

Benefits:

• Dental insurance
• Employee discount
• Health insurance
• Life insurance
• Paid sick time
• Paid time off
• Retirement plan
• Vision insurance

Work Location: In person

Salary : $22