Job Information
Primary Health Care Bilingual Health Benefits Specialist II - Ames Clinic in Ames, Iowa
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.
As a Health Benefit Specialist II (HBS II) you will work in both medical and dental clinics moving seamlessly between departments as needed. You will be responsible for verifying insurance coverage and ensuring the correct payer is identified for each patient visit, working with patients to ensure they are registered for medical or dental insurance coverage that they are eligible for, supporting patients through the insurance application process, and determining eligibility for sliding fee services. You will be part of the revenue cycle and will partner with billing services to ensure reimbursement for medical and dental services provided. You will demonstrate the PHC iCare values in all interactions.
Candidates must have proficient English and Spanish language skills to be eligible for this position.
What's Great About This Position?
Enjoy work-life balance with a stable work schedule. This position will work approximately 40 hours per week, typically Monday - Friday 8 AM - 5 PM.
Earn 4 weeks of PTO throughout your first year of employment and enjoy paid holidays as well.
Continue to develop your skills and grow your career through PHC’s training opportunities including: PHC University, Emerging Leaders, and medical and dental assistant training programs.
What You Will Do
Maintains knowledge about enrollment and verification processes for both medical and dental services at PHC.
Ensures a consistent revenue cycle process in medical and dental clinics by reviewing patient schedules to identify patients with upcoming appointments who need assessment for financial assistance, other available benefits, or payment plans. Communicates with patients about anticipated cost of visit, if applicable.
Performs insurance verification prior to patient appointments to confirm active coverage for the visit. Backs up Clinic Office Specialist s in completing robust confirmation calls as needed.
Meets with patients as needed to help them apply for Medicaid (including Hawk-I), Marketplace coverage, or other insurance programs. Acts as patient advocate throughout the application and enrollment process. Monitors the status of the applications from initial submission through approval, intervening as necessary to move the process forward. Helps patients apply for the sliding fee program.
Completes necessary back-billing for applicable patients when insurance is identified or approved after the visit. Answers patients’ questions related to billing statements and collaborates with the billing department to support patients in resolving issues related to medical and dental bills. Verifies and follows-up on patient credits and/or refunds that are identified through patient question or account verification processes.
Creates and distributes good faith estimate letters in accordance with the No Surprises Act and upon patient request.
Maintains patient financial assistance files including electronic notes in registration and/or financial note files.
Completes mon thly laboratory and radiology billing and dental prior authorizations .
Monitors and reports on payer mix for assigned clinic and works with Clinic Administrator to address unfavorable payer mix changes.
Conducts outreach and enrollment activities including annual Marketplace enrollment events. May provide assistance at various locations, including PHC clinics, community agencies.
Collects and processes patient payments and applies payment to the correct visit.
Qualifications You Need to Bring
Required:
High school diploma or equivalent.
Two years of experience in healthcare, human services, or finance; or three years in customer service.
Effective verbal and written English communication skills.
Effective verbal and written Spanish communication skills.
Professionalism and excellent customer service skills.
Detail oriented with a high degree of accuracy.
P roblem-solving and critical thinking skills.
Takes initiative and is dependable.
Team oriented with the ability to work collaboratively.
Basic math skills.
Ability to understand and follow written instructions.
P roficiency using Microsoft Office and Google Suite computer applications.
Ability to learn and effectively use the electronic health record system.
O rganization, prioritization, and time management skills.
Strong interpersonal skills with ability to establish and maintain effective working relationships with a diverse group of individuals.
Licenses & 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.
Preferred:
Higher education degree in related field.
Senior Health Insurance Information Program (SHIIP) Counselor Certification.
Work experience in a community health center, medical or dental clinic, or in the essential functions of the position.
Ability to use a multi-line telephone system.
Knowledge of clinical terminology.
Knowledge of health insurance eligibility requirements, enrollment processes, and insurance impacts on revenue cycle.
We Take Care of Our People
Your experience and skills determine your base pay. The hiring range for this position is typically $18.65 - 23.32 per hour. Candidates with extensive work experience related to this position may be considered for additional compensation up to the pay grade maximum of $27.98 per hour. PHC also offers a comprehensive benefits package, including:
Generous PTO accrual (equal to 4 weeks at end of 1st year) plus paid holidays
License/certification fee reimbursement
Paid time off for continuing education & continuing education reimbursement
Tuition reimbursement program
401k with company match
Medical insurance
Dental insurance
Vision insurance
Life & disability insurance
Flexible spending & health savings accounts
Supplemental accident & critical illness insurance
Discounts on pet insurance
Visit https://phciowa.org/careers for a summary of PHC’s benefits.
Join the PHC Community
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