Patient Benefits Coordinator

$39,520 - $43,680/Yr

Native American Connections - Phoenix, AZ

Full-time

Phoenix, AZ

Social Assistance

About the position

The Patient Benefits Coordinator at Native American Connections plays a crucial role in assisting patients in obtaining and maintaining health insurance coverage through various programs such as AHCCCS, Medicare, and private insurance. This position is integral to ensuring that patients understand their entitlements and have access to the necessary resources to navigate the complexities of health insurance. The coordinator works closely with the patient's care team to identify and address any barriers that may hinder the patient's ability to maintain maximum insurance coverage. Additionally, the coordinator assists patients in obtaining proof of tribal enrollment and accessing other eligible benefits, ensuring that they receive the support they need to improve their health outcomes. In this role, the Patient Benefits Coordinator interviews patients eligible for Medicare and AHCCCS benefits, guiding them through the application process and ensuring they are aware of their entitlements. The coordinator is responsible for implementing effective screening and interviewing methods to maximize the identification of individuals who are eligible for benefit resources. Collaboration with clinic staff, social services, and other disciplines is essential to develop a comprehensive register of eligible patients. The coordinator evaluates patients for existing insurance coverage and eligible federal and state benefit programs, advocating for patients to utilize alternate resources such as Medicare, AHCCCS, and private insurance. The position requires the coordinator to visit patients to finalize necessary documents for benefit approval, obtain relevant medical evidence, and submit applications accurately to governmental agencies. Following up on pending eligibility claims and maintaining communication with patients and caseworkers is vital to ensure timely processing and completion of applications. The coordinator also assists clients in obtaining copies of certificates of Indian blood and/or Tribal identification, ensuring that all information is accurately entered into the Electronic Health Record. Maintaining knowledge of current information privacy laws and patient rights is essential in this role, as is the ability to manage multiple tasks in a fast-paced environment while providing excellent customer service.

Responsibilities

• Interviews all patients eligible for Medicare and AHCCCS benefits to ensure they understand their entitlements.
• Assists families and individuals in an application for, and use of benefit resources such as AHCCCS and Medicare.
• Assures maximal identification of persons who have, and/or eligible for benefit resources, by implementing screening and interviewing methods.
• Works with patient registration/receptionist, social services, and other disciplines that may assist in developing registers of eligible patients through their current activities.
• Evaluates patients for existing insurance coverage, and eligible federal and state benefit programs.
• Provides leadership and acts as an advocate for patients in the effective utilization of alternate resources such as Medicare, AHCCCS, Department of Veterans Affairs (DVA), private insurance and other resources.
• Works closely with clinic staff in the identification and utilization of all alternate resources available to populations served.
• Visits with patients to finalize documents necessary for benefit approval.
• Obtains legally relevant medical evidence, physician statements, and all other documentation required for eligibility determination.
• Submits patient's applications accurately online and to the separate governmental agencies, follows application status to completion and updates account with the verified third-party information.
• Provides benefit information and interprets rules and regulations for patients.
• Follows up on all pending eligibility claims and addresses any concerns of patients.
• Initiates and maintains proper follow-up with patient and governmental agency caseworkers to ensure timely processing and completion of all mandated applications and accompanying documentation to ensure renewed program eligibility.
• Completes applications for eligibility of service; including securing and reviewing backup documentation, computing income, and determining hours of care for which client is eligible and may issue proper documents to clients for eligibility continuation.
• Verifies information for accuracy and completeness against existing records and ensures appropriate signatures are obtained on all necessary forms.
• Assists clients to gain copies of certificates of Indian blood and/or Tribal identification/driver's license.
• Enters information in the Electronic Health Record.
• Maintains knowledge of current information privacy laws and issues related to health information, the release of information, and patient rights.

Requirements

• Associate's degree from a 2-year college or technical school in Social Services or Health-related field; or three years related experience; or equivalent combination of education and experience.
• An understanding of community resources, eligibility and entitlement funding sources.
• Knowledge of and experience with Federally Qualified Health Center requirements and billing related to Medicaid, Medicare and private insurance.
• Knowledge of Native American Connections and the target population served.
• Excellent organizational skills, attention to detail, and ability to manage multiple tasks and priorities in a fast-paced environment.
• Excellent communication and interpersonal skills, with the ability to interact effectively with patients, healthcare providers, and external stakeholders.
• Ability to work independently and collaboratively in a matrix organization.
• Demonstrates excellent written and oral communication skills.
• Must demonstrate critical thinking, problem solving, organizational and time management skills.
• Proficiency in Microsoft Office and other grant and operational management platforms.