Benefits Coordinator - Healthcare jobs in Alaska

POSITION TITLE: Benefit Coordinator

DEPARTMENT: Patient Services

PAY GRADE: 11

FLSA STATUS: Non-Exempt

ESC CODE: 43-4061

FUNDING SOURCE: HRSA

Opening: May 30, 2024

Closing: June 10, 2024

Position Summary:

This position is responsible for advocating for patients in the effective utilization of alternate resources and ensure that all patients who are eligible for alternate resources are identified, contacted and encouraged to apply for and maintain eligibility for available benefits.  This position will assist patients in understanding their insurance benefit and will work with insurance companies on the patient’s behalf to communicate insurance concerns, and manage any insurance disputes.

This position requires compliance with Health Center’s compliance standards, including its Standards of Conduct, Compliance Program, and policies and procedures. Such compliance will be an element considered as part of the position’s regular performance evaluation. 

Essential Functions:

1. Prioritize Purchased Referred Care (PRC) referrals and verify patients’ eligibility for services.
2. Determine eligibility of patients and ensure appropriate identification of patients who have or are eligible for direct services.
3. Determine eligibility of patients and ensure maximum identification of patients who have or are eligible for alternate third-party resources by effectively implementing screening and interview methods.   
4. Work closely with other YCHC staff in identification and proper utilization of all alternate resources available to all patients.
5. Develop and maintain a network of contacts in local, state, tribal and federal agencies to better assist patients in developing other resources, including all agencies and organizations that provide alternate resources for health care.
6. Follow up on all pending eligibility claims and work closely with families and agencies until completion of application.
7. Work with patients to appeal denials from third resources as applicable.
8. Supports medical staff to obtain pre-authorization for services.
9. Document all encounters and work activities on finding/maintaining alternate resources; update patient’s electronic record; provide monthly reports to supervisor.
10. Continually research all alternate resources, exploring all available options for patient coverage; ensure application and information on alternative resources are readily accessible to the patients.
11. Assist patients and their families with processing all applications for alternate resources. Provide interpretation of the rules and regulations from the organization supplying the benefit, as well as the rules governing Tribal/IHS services. Review with patients what is covered and how to use those services.
12. Serves as back up for Patient Registration and preforms other dities as directed.
13. Readily accepts referrals from patient registration to assist patients.
14. Organize Community Outreach and Enrollment events and actively participate in other community programs events.
15. Must comply with federal laws and regulations as required by the Health Insurance Portability and Accountability Act (HIPAA).

1. Performs related duties.

Knowledge, Skills and Abilities:

• Knowledge of and ability to apply alternate resources regulations.

• Knowledge of various third-party payers, applications processes, and eligibility requirements.
• Knowledge of computers and job-related software programs and office equipment.
• Ability to work with personal computer and utilize a variety of software applications.
• Ability to communicate clearly and effectively, both orally and in writing.
• Ability to effectively meet and communicate with the public.
• Ability to organize the multiple demands of the job.
• Skill in providing exceptional customer service.
• Skill in prioritizing and planning.
• Skill in interpersonal relations.
• Skill in the maintenance of files and records.
• Skill in the use of such office equipment as a computer, scanner, fax machine, and copier.
• Skill in oral and written communication.

Work Environment/Physical Demands:

The work involves moderate risks or discomforts that require special safety precautions, including exposure to contagious diseases. Employees may be required to use protective clothing, such as masks, gowns, coats, boots, goggles, gloves, or shields.

The work is sedentary. Typically, the employee sits comfortably to do the work.  However, there may be some walking; standing; bending; carrying of light items, such as papers, books, or small parts; or driving an automobile. The employee must be able to read, write, speak and hear.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Supervisory and Management Responsibility:

This position has no formally assigned supervisory responsibility or authority.

Minimum Qualifications:

• High school diploma or equivalent.
• Three (3) years of progressively responsible, related experience, sufficient to perform the major duties of the position. Experience in a health care business office, medical insurance office, eligibility determination or other medical office related experience is preferred.
• Ability to obtain a Certified Fee Agent
• Ability to become a Notary Public
• Full COVID-19 vaccination required unless a documented medical or religious exemption is approved. 
• Possession or ability to readily obtain a valid driver’s license issued by the State of Alaska with a clean driving record.
• Must successfully pass a criminal and background check.

We welcome applications from all suitably qualified persons regardless of their race, sex, disability, religion/belief, sexual orientation, or age.

THE YAKUTAT TLINGIT TRIBE IS A DRUG FREE WORKPLACE. THIS POSITION MAY BE SUBJECT TO RANDOM DRUG TESTING AND CRIMINAL HISTORY CHECK.  

NATIVE AMERICAN PREFERENCE WILL BE APPLIED TO HIRING OF THIS POSITION AS DEFINED IN TITLE 25, US CODE, CHAPTER 14, SUBCHAPTER V, SUBSECTION 273 AND 274.  WE ARE AN EQUAL OPPORTUNITY EMPLOYER WITH PREFERENCE GIVEN TO QUALIFIED NATIVE AMERICAN/ALASKA NATIVE APPLICANTS IN ACCORDANCE WITH FEDERAL LAW AND TRIBAL POLICY.