Benefits Specialist

Salary $16-$17.50 / hourly DOE

When you join our team, you will receive:

• 9 paid holidays per year and paid time off accrual
• Access to health coach and wellness incentives
• Tuition reimbursement up to $3,000
• Medical Vision, and Dental
• S.A., H.R.A, F.S.A. (with select medical plans)
• Group Life/AD&D and Short-Term Disability
• Long-Term Disability and Life/AD&D
• 403(b) retirement plan with company match
• Employee Assistance Program

The Benefit & Eligibility Specialist is responsible for navigating and optimizing various benefit programs while assessing and assisting members with obtaining benefits. Assist members with AHCCCS eligibility and enrollment. Establish positive, effective, and professional relationships with members, families, colleagues and other components of the healthcare payor system.

We’re looking for someone with the skills, experience and credentials:

• Verifies, ensures accuracy, and updates patient demographics and insurance information.
• Assist Office Assistants in the maintenance of accurate, up-to-date insurance verification.
• Use online web-based verification systems and review real-time eligibility responses to ensure the accuracy of insurance eligibility.
• Collect, verify, and communicate necessary information with members’ insurance carriers to obtain benefits and eligibility information.
• Complete, process, submit, and track prior authorizations.
• Initiate and assist patients with completing applications for Medicaid, Medicare, and SSI/SSDI.
• Screen persons to determine eligibility for Medicaid assistance and re-determine their continuing eligibility.
• Establish rapport and credibility with customers and providers by providing excellent customer service in a professional manner.
• Perform quality checks on all eligibility initiatives and ensure there are processes for all members who do not have a valid, accurate, current insurance.
• Process eligibility case files within the required time frames established by applicable funding source.
• Facilitate eligibility screening and ongoing monitoring.
• Process eligibility files into the company EHR/EPM system.
• Investigate and resolve denial cases of members who lose eligibility.
• Perform other administrative tasks to support the operations of the outpatient site.
• Adhere to all agency policies, licensure, and training requirements.
• To ensure compliance & adequate services, additional job duties may be required to meet the needs of the program and or department.

• High School Diploma/GED
• Minimum of two years’ experience in an office clerical setting.
• Experience working in a medical and or behavioral health setting is highly preferred.
• Must have a fingerprint clearance card issued by the AZ Department of Public Safety or be eligible to receive one within eight (8) weeks of hire.
• TB Test clearance required at the time of hire and annually.

• Proficiency in typing, using computer software, i.e., EHR/EMR systems and MS Office.
• Ability to maintain confidentiality and adhere to all HIPAA regulations.
• Demonstrated ability to communicate, problem solve, and work effectively in an individual and team environment.
• Demonstrated ability to remain calm and use the proper de-escalation methods in crisis situations.
• Demonstrate an understanding of current Medicaid/Medicare/Marketplace information and systems.
• Ability to adhere to agency procedures, licensing and accreditation standards related to health and safety are maintained.
• Demonstrate superior work habits to include, but not limited to the following: time management, initiative, role modeling, leadership, organizational skills, and multitasking.
• Ability to work in a fast-paced environment.

Copa Health, powered by Marc Community Resources and Partners In Recovery, is an Equal Opportunity Employer – All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, disability status, protected veteran status or any other characteristics protected by law. Pre-Employment Criminal Background and Drug Testing Required. EOE.