Maniilaq Association

05/26

Title:  Patient Health Benefits Specialist I/II                                                                                                 Pay Grade: 26 / 27

Program:  Patient Financial Services                                                                                                               Status:  Non-Exempt

Housing Priority: None                                                                                                                                    Covered:  No

POSITION SUMMARY:

The purpose of this position is to identify opportunities to encourage eligible patients and community members to obtain health benefits that may offset costs associated with the patient’s treatment. This position will determine what program patients are eligible for and assist them in completing applications. Such as Medicaid, Medicare, T-SHIP, ect. This position will also track current patient that are receiving inpatient services and screen for eligible programs. This position will work with patients in all village locations and may be required to travel. This position requires to keep logs of eligibly status and maintains appropriate data to submit to Maniilaq leaders or state entities. Reports directly to the Patient Financial Services director or designee.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

1. Identifies patients and community members who may be eligible for Health Benefits if they are uninsured or underinsured.
2. Must gain knowledge of all local, state or government resources available in order to enroll patients, e.g., Medicaid (with an emphasis on the Alaska Children’s Health Insurance Program), T-SHIP, Medicare, VA, private insurance.
3. Utilizes internal and external resources to ensure current or future coverage is obtained.
4. Must utilize customer services skills in eliciting sensitive information from patients and community members regarding personal relationship, finances, family history, etc.
5. Assists patients to complete application, new, appeal, or renewals.
6. Use resources to ensure enrollment to any programs are done efficiently, such as online submission.
7. Keep record of all applications submitted for appropriate follow-up to avoid deadline or due dates.
8. Ensures procedural compliance of privacy or HIPAA is followed and adhered to.
9. Maintains communication and a cooperative relationship with various Federal, State, Municipal, Civic, Native and other service organizations to obtain and use resources of referred patients.
10. Will comply with state, government or entities to gain access to their portals.
11. Attend all training courses to stay certified for programs or systems. And attend all meeting associated with this position.
12. Works closely with revenue cycle team to ensure all EHR system have current up to date on eligibility.
13. Will work with all other services line within Maniilaq Healthcare to ensure EHR has current up to date information.
14. Travels frequently for training and in small planes to villages and by snow machine and other non-traditional means to canvas communities and participate in enrollment projects for eligible parties.
15. Establishes a routine program for patient education and regular Public Service Announcements to achieve targeted goal.
16. Performs patient registration assuring all information is current in the RPMS system.
17. Performs other duties as assigned as needed by program.
18. Utilizes software available to manage/monitor cases and able to make updates and reports as need.
19. Must be able to stay organized and pay attention to detail to avoid clerical errors when submitting applications.
20. Resource Specialist II must maintain the program budget and make sure grant guidelines are followed.

MINIMUM REQUIREMENTS:

Patient Health Benefits Specialist I:

High School Diploma or equivalent required.  Requires one year’s relevant experience. Prefer six months’ registration experience. Must be able to type well enough to accomplish job duties.  Basic Microsoft Word and Excel experience required. Inupiaq speaking ability is preferred.  Must be able to communicate professionally and present presentations to explain various program requirements to patients, whether individuals or groups. EHR experience preferred but not required.  Must be able to do public service announcements.  Must be able to travel overnight to villages in small planes.  Ability to lift 40 pounds.  Ability to effectively communicate and work well with others.

Patient Health Benefits Specialist II:

Must meet all of the above qualifications of the Benefit Resource Specialist I.  Requires additional two years of relevant work experience. Must demonstrate proficiency in knowledge of Medicaid, Medicare, VA, T-SHIP, third party payor State and Federal rules and regulations. Must be able to work with minimum or no supervision.  Must be able to maintain program budget and an understanding of grant guidelines.

DISCLAIMER

The above statements are intended to describe the general nature and level of work being performed by people assigned to this job.  They are not intended to be considered an exhaustive list of all responsibilities, duties and skills required of personnel in this job, and the employer reserves the right to revise or change this description.  This description does not constitute a written or implied contract of employment.  To perform this job successfully, an individual must be able to satisfactorily perform each of the above essential duties and meet physical demands.  Reasonable accommodations may be made to enable individuals with disabilities to meet those conditions.