Health Benefits Specialist II – Primary Health Care, Inc. – Ames, IA

Essential Functions

• Meets with patients/clients to identify relevant financial assistance and/or payer sources, and identifies additional available benefit(s) for medical and dental. This includes screening for entitlement programs, including state programs, and screening for other supportive services within Primary Health Care, Inc. Assists patients in fully completing the necessary applications and/or paperwork. May provide assistance at various locations, including PHC clinics, community agencies, & in patients/client’s homes.
• Performs insurance verification utilizing provided tools and ensures network coverage at patient’s request for patients within Primary Health Care, Inc.
• Reviews patient schedules to identify and meet with patients with upcoming appointments who need assessed for potential financial assistance, potential payer sources, to identify additional available benefits, and who have a balance over $100.
• Act as a patient advocate throughout the health benefit enrollment process. Answer patients/clients 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 provides necessary patient education to ensure continuity of health coverage and other benefits.
• Maintain complete and accurate patient financial assistance files which includes electronic notes in registration/financial note files.
• If applicable, review monthly laboratory and radiology billing to verify eligibility for PHC financial assistance program and communicates adjustments to appropriate vendors. Work in collaboration for PHC billing department to complete necessarily back-billing for patients who gain access to entitlement programs and/or private insurance.

Minimum Qualifications

• High school diploma or equivalent
• One year experience in benefits and/or resource coordination
• Two years customer service experience
• Knowledge of third party payers for medical and dental and associated regulations
• Bilingual, Spanish & English verbal and written language proficiency for all locations

Typical Work Hours

This position typically works 40 hours per week. The schedule for this position will typically be Monday – Friday 8 AM – 5 PM.

Compensation & Benefits

Compensation offered is based on the individual’s related experience and education.

This position is eligible for PHC’s benefit package. Visit www.phciowa.org/careers for a summary of PHC’s benefits.