Benefit Coordinator-US BASED APPLICANTS ONLY; NO SPONSORSHIP AVAILABLE

GENERAL STATEMENT :

Responsible for obtaining insurance pre-authorizations, assisting patients with obtaining and maintaining health insurance coverage, submitting insurance claims, and following up on account receivables.

DUTIES AND RESPONSIBILITIES :

• Assist patients with the process of obtaining and maintaining maximum insurance coverage, including identifying available health care insurance options as needed.
• Remain current on available insurance options, including eligibility and enrollment requirements.
• Screen new patients' referrals for insurance coverage, obtain any necessary pre- authorization, and provide timely approval for admission.
• Work closely with members of the patient's care team to address any barriers to maintaining insurance coverage.
• Enter and maintain insurance coverage and related demographic information in RPMS.
• Monitor the status of applications for patients applying for Medicaid / Medicare with the PRC.
• Assist with applications for additional programs offered to patients.
• Work closely with community and governmental agencies, including Social Security and Medicare and private insurance companies to assist patients in resolving insurance eligibility.
• Bring to the attention of the Billing department any insurance or coverage issues.
• Reports weekly status / workload to Supervisor.
• Reach out to patients regarding additional information required for Medicaid / Medicare / VA eligibility.
• Entered detailed records in the RPMS as to the status of patient application / eligibility.
• Participate in organizational process improvement meetings.
• Works closely with Patient Registration, PRC, Nursing, and specialty clinics to identify and assist patients with any alternate resource patient may qualify for.
• Performs continuous research and updating information involving changes in rules and regulation for alternate resources.
• Other duties and / or tasks that may be assigned on an as-needed basis.

QUALIFICATIONS :

APPLICATION REQUIREMENTS :

Preference will be given to qualified Eastern Shoshone tribal members, then other qualified federally recognized Indian tribal members and then other qualified candidates.

Any offer of employment is contingent upon a negative drug test, reference checks and background check. Refusal to undergo required testing or testing positive will render the applicant ineligible for employment.

EOE