Patient Health Benefits Specialist

## Patient Health Benefits Specialist
* Knows, understands, incorporates, and demonstrates the Mission, Core Values, and Vision in     behaviors, practices, policies, and decisions.
* Maintains collaborative, team relationships with peers and colleagues to contribute to the working group’s achievement of goals effectively, and to help foster a positive work environment.
* Protects confidentiality/privacy in verbal, written, and electronic forms of communication or information sharing.
* Raises concerns in an appropriate manner and according to policy.
* Consistently exhibits behavior and communication skills that demonstrate SEARHC’s commitment to superior customer service, including quality, care, and concern with each and every internal and external customer.
* Provides exceptional customer service in assisting patients enrolling in third party payers including Medicaid, Medicare, Denali Kid Care, VA, Federal Insurance Marketplace, and Sliding Discount. Obtains and documents necessary information accurately and timely.
* Enter data into MapsIQ health benefit tracking software and other systems. Monitors and maintains statuses from initiation to resolution. Tracks additional data elements as necessary.
* Distributes health benefits material to patients, community members, partner organizations and businesses to build coverage option awareness.
* Coordinate with local and regional organizations and Tribal Nations to build awareness of coverage options.
* Completes and attends all required training programs and participates in conference calls, webinars or other professional or team development activities.
* Reviews, verifies, and confirms current third-party payer information in EHR.
* Provides administration assistant type work to Health Benefits department including mail outs, data clean up, and other assigned duties.
* Coordinates and leads small scale projects.
* Facilitate educational events and presentations.
* Proficient in public speaking
* Makes meaningful improvement to services, program, processes, and organizational effectiveness that creates new value for patients and employees.
* Acts as a resource, mentor, and trainer for entry-level Health Benefits Specialist I personnel and Patient Access Representatives, as appropriate.
* Orients new Health Benefits Specialist I staff to the department and SEARHC systems and processes.
* Responds to questions on standard procedure and best practices from team members.
* Communicates effectively with patients, physicians, and/or other departments regarding delays or issues relating to health insurance programs.
* Work closely with the Financial Counselors and Patient Access team to ensure coverage is current and documented appropriately in the record.
* Responds to inquiries regarding status of health coverage by assessing the request and evaluating the circumstances to provide the needed information.
* Demonstrates superior customer service to all external and internal customers.
* Communicates effectively with patients, physicians, and/or other departments regarding delays or issues relating to authorizations, PRC Travel and patient appointments.
* Meets team metric standards and expectations consistently.
* Maintains strict confidentiality at all times.
* Identifies compliance/ethics issues and brings forth recommendations for operational improvement.
* Ensures successful adherence to policies, procedures and changes to the organization.
* Complete and support additional patient access related activities as assigned.
* Makes recommendation for FAP/HRSA approval
* Other duties as assigned.
* High School Diploma or equivalent – required.
* Bachelor's degree or 3+ years benefits enrollment experience or equivalent combination of education and experience or demonstrated proficiency
* Certified Application Counselor (CAC) with CMS or obtain within 45 days of hire
* Medicare Counselor Certification or obtain within 6 months
* Completion of Department of Veterans Affairs-Tribal Veteran Representative training or obtain within 1 year of hire
* Understanding and/or willing to learn tribal health programs and alternate resources
* Knowledge and demonstrated use of customer service…