Health Benefits Specialist Ii - Marshalltown Clinic

Are you looking for an opportunity to do amazing work helping others? You've come to the right place. Let's make a difference!

Primary Health Care (PHC) was founded in 1981 by Dr. Bery Engebretsen in Des Moines, IA. Our mission has remained unchanged since that time, to provide healthcare and supportive services to all, regardless of insurance, immigration status, or ability to pay.

Based on the needs of the communities we serve, PHC offers a spectrum of medical and dental services including family practice, behavioral health, HIV care and services, and pharmacy. PHC’s Homeless Support Services is the entry point for serving people experiencing homelessness in Polk County. Enabling services are available to help patients with benefits enrollment, case management, transportation, translation, and patient education. We currently have locations in Ames, Des Moines, & Marshalltown.

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As a Health Benefit Specialist II, you will provide excellent customer service in medical and dental clinics while delivering benefits education, outreach, and in-person assistance to patients to obtain and maintain health coverage and other benefits. Coordinates with PHC team members to provide positive service experiences for patients. Spanish language skills are preferred but not required.

What's Great About this Position?

• Impact patient care by linking patients with resources they need to get the care they deserve.
• Enjoy work-life balance. Earn 4 weeks of PTO during your first year of employment and enjoy 8 paid holidays per year.
• Evening & weekend hours are not required. This position typically works 40 hours per week, Monday - Friday 8 AM - 4:30 PM.

1. Ensures a consistent revenue cycle process in a medical and dental clinics:
   1. Reviews patient schedules in medical and dental clinic scheduling systems to identify patients with upcoming appointments who need assessment for financial assistance, payer sources, other available benefits, or payment plans.
   2. Performs insurance verification and confirms network coverage at patient’s request.
   3. Maintains complete and accurate patient financial assistance files which includes electronic notes in registration/financial note files.
   4. If applicable, reviews monthly laboratory and radiology billing to verify eligibility for PHC financial assistance program and communicates adjustments to appropriate vendors. Works in collaboration with PHC’s billing department to complete necessary back-billing for patients who gain access to entitlement programs and/or private insurance.
2. Conducts outreach and enrollment activities related to medical and dental care:
   1. Assists patients in completing the application process for appropriate benefits and programs. May provide assistance at various locations, including PHC clinics, community agencies, & in patients' homes.
   2. Acts as a patient advocate throughout the application and enrollment process.
   3. Answers patients’ questions related to billing statements and collaborates with the billing department to support patients in resolving issues. Identify and support patients to address patient barriers and provide necessary patient education to ensure continuity of health coverage and other benefits.
3. Monitors payer mix for assigned clinic and works with Clinic Administrator to address unfavorable payer mix changes.

Qualifications You Need to Bring

• High school diploma or equivalent
• Two years in a healthcare environment or three years in a customer service role.
• Excellent customer service skills
• Effective English communication skills, written and verbal
• Ability to think critically to effectively resolve problems
• Initiative
• Dependability
• Able to provide own transportation to other clinics and off-site work locations as assigned
• Effective listening skills
• Contributes to a team approach to care
• Ability to follow written and verbal instructions
• Ability to perform arithmetic and calculate annual income
• Accurate and efficient typing skills
• Efficiently performs basic computer functions, internet navigation, and email
• Demonstrates attention to detail in work
• Prioritizes assigned work
• Establishes and maintains effective working relationships with a diverse group of individuals
• Interacts with others in an empathetic manner while maintaining professional boundaries
• Remains calm and works through difficult interactions
• License/Certifications: Presumptive Eligibility Certification required within 4 months of starting in the position and must be maintained throughout employment thereafter, Certified Application Counselor (CAC) certification is required within 12 months of starting in position and must be maintained throughout employment thereafter.