PATIENT HEALTH BENEFITS SPECIALIST

SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement.

Working at SEARHC is more than a job, it’s a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health, dental, and vision benefits, life insurance and long and short-term disability, and more.

The Health Benefits Specialist is responsible for providing frontline health benefits enrollment to patients. Serves as a resource and referral person for patients for initiating health care coverage.

Salary:  $21.29-$26.55 DOE   

• Meets with patients and/or families to determine and resolve third party payors available. 
  • For patients who are not insured, screens and evaluates whether the patient may qualify for any known payer sources, including Medicaid, Medicare, Denali Kid Care, VA, Federal Insurance Marketplace, Sliding Discount.
  • As alternate payors are identified, provides assistance to the patient for the enrollment process. 
  • Documents necessary information in an accurate and timely manner. 
• Enters data into MapsIQ health benefit tracking software and other systems. Monitors and maintains statuses from initiation to resolution. Tracks additional data elements as necessary.  
• Establishes payment plans and collects true self-pay and self-pay residual balances, as appropriate. 
• Distributes health benefits material to patients, community members, partner organizations and businesses to build coverage option awareness.   
• Coordinates with local and regional organizations and Tribal Nations to build awareness of coverage options. 
• Reviews, verifies, and confirms current third-party payer information in EHR. 
• Provides administrative assistance to Health Benefits department including mail outs, data clean up, and other assigned duties.  
• Completes and attends all required training programs and participates in conference calls, webinars or other professional or team development activities. 
• Other duties as assigned.

Education:

• High school diploma or GED - required.

Experience:

• Two years of administrative or customer service experience – required. 
• One year experience performing related revenue cycle duties – preferred 

Licensure and Certification:

• Certification as CMS Certified Application Counselor (CAC) or obtain within 45 days of hire

Other:

• Ability to travel by all forms of transportation to outlying communities for outreach efforts
• Proficient in data entry and computer applications

Knowledge, Skill, Ability and Behavior:

• Administrative and clerical knowledge including word processing, managing files and records, office procedures, computer software 
• Excellent customer service skills working with patients in difficult and complex situations 
• Read and comprehend instructions, correspondence, and memos 
• Effectively communicate information verbally and through written communication   
• Actively look for ways to help people 
• Excellent interpersonal skills and have the ability to interact on a professional level with individuals from diverse backgrounds 
• Performs job with minimal supervision and demonstrates problem-solving skills 
• Time-management and organizational ability
• Proficient in Microsoft Office Products including Word, Excel and PowerPoint 
• Other SEARHC provided applications 

Safety and Risk Management Responsibilities: 

Employees are responsible for complying with safe work rules; reporting all accidents and injuries immediately; cooperating in all accident and injury investigations; reporting defective equipment and unsafe conditions. 

Physical Demands: 

While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to stand; walk; sit; use hands to finger, handle or feel and reach with hands and arms.  The employee is occasionally required to climb or balance; stoop, kneel, crouch or crawl. 

The employee may frequently lift and/or push/pull up to 25 lbs. 

Work Environment: 

The noise level in the work environment is usually moderate. 

The setting for this role will include office and healthcare settings. Exposure to controlled temperature environments, both hot and cold, is to be expected. 

The normal work routine involves no exposure to blood, body fluids or tissues.  Persons who perform these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid or to be potentially exposed in some other way.