Health Benefits Specialist I, II - $2,500 Sign-On

About the role

The Health Benefits Specialist I, II plays a critical role in supporting the administration and management of health benefit programs within the healthcare and social assistance sector. This position is responsible for ensuring that eligible individuals receive accurate information and timely access to their health benefits, contributing to overall employee satisfaction and well-being. The specialist will collaborate with internal teams and external vendors to resolve benefit-related inquiries, process claims, and maintain compliance with regulatory requirements. By analyzing benefit plans and assisting with enrollment processes, the role helps optimize the delivery and utilization of health benefits. Ultimately, this position ensures that health benefits are effectively communicated and administered, supporting the organization's commitment to quality care and employee support.

Responsibilities

• Assists patients with inquiries related to health benefit plans, coverage details, and claims processing.
• Processes enrollment, changes, and terminations in health benefit programs accurately and within established timelines.
• Collaborates with insurance carriers, third-party administrators, and internal departments to resolve benefit issues and discrepancies.
• Maintains up-to-date knowledge of health benefit policies, regulations, and compliance requirements to ensure accurate information dissemination.
• Prepares and maintains detailed records and reports related to health benefits administration and utilization.
• Screens and interviews patients to determine eligibility for alternate health resources (AHR) such as Medicaid, Denali Kid Care, Medicare, VA, Tribally Sponsored Health Insurance (TSHIP), HRSA/Sliding Fee discounts, or other health programs.

Skills

• Utilizes strong communication skills daily to provide clear and empathetic assistance to patients navigating their health benefits.
• Analytical skills are essential for reviewing benefit plans, processing claims, and identifying discrepancies or opportunities for improvement.
• Proficiency with benefits administration software and databases enables efficient management of enrollment and claims data.
• Knowledge of regulatory requirements ensures compliance and accurate dissemination of information.
• Collaboration and problem-solving skills are applied regularly to coordinate with vendors and internal teams, ensuring seamless benefits delivery and resolution of issues.