Benefit Coordinator - Benefit Coordination

Responsibilities

• Advocates for WRFCHC patients in securing alternate resources such as Medicare, Medicaid, Department of Veterans Affairs, State Programs, Third Party Liability, and Children's Special Health Services.
• Identifies patients who may be eligible for alternate resources through the effective utilization of pre-screening and interviewing methods.
• Understands and recognizes what programs each patient/family would be eligible for based on their unique circumstances.
• Works closely with all WRFCHC departments in the identification and utilization of all alternate resources available to the patient population.
• Helps patients complete applications for benefits and assists with enrollment processes.
• Provides information and resources to patients about their benefits, coverage options, etc.
• Connects patients with appropriate resources and support services.
• Aids in the coordination of care by maintaining open communication with patients, families, and healthcare providers.
• Maintains accurate records of patient information, benefits, and eligibility status.
• Ensures compliance with all applicable regulations and guidelines related to benefits administration.
• Addresses any issues or concerns that may arise with patient benefits.
• Interviews patients using established criteria.
• Stays current on different programs' regulations and policies.
• Responds to referrals from patient registration, Purchased Referred Care (PRC), and other departments/committees as needed.
• Educates different WRFCHC departments on updates to programs (private insurance, Medicaid, Medicare, etc.).
• Provides outreach, education, and assistance regarding alternate resource programs to patients and community members.
• Timely alternate resource application follow up.
• Notifies pharmacy, business office, and PRC of approved alternate resources with effective date of coverage.
• Prepares reports for supervisor and/or administration.
• Documents patient eligibility, alternate resource approval/denial, screenings, application status in appropriate Electronic Health Record and/or spreadsheets.
• Partners with local and tribal programs to provide outreach and education.
• Works closely with the Social Security Administration on local and regional levels.
• Works closely with the Tribal TANF and DFS to establish eligibility for alternate resources.
• Works with Social Services and other entities that may assist in the development of a registry of eligible patients.
• Willingness to travel to a patient's residence for assistance in application completion.
• Willingness to become a Certified Application Counselor through ACA Marketplace.
• Other duties as assigned to maintain and enhance the operation of the department.

Qualifications

Must have a strong understanding of healthcare systems and patient needs.

Must be able to work independently and manage multiple tasks simultaneously.

Must have excellent interpersonal skills and the ability to communicate effectively with patients, families, and healthcare providers.

Must be able to work flexible hours, including evenings and weekends, due to the nature of the job.

Must be willing to travel to a patient's residence for assistance in application completion.

Must be willing to become a Certified Application Counselor through ACA Marketplace.