The Benefits Counselor will be knowledgeable about eligibility requirements and the benefit packages associated with health insurance coverage options available to Health Center patients. The Benefits Counselor will facilitate the assessment and subsequent enrollment of eligible uninsured patients. She/he will be expected to maintain daily logs, complete and submit reports on contacts, applications submitted, and outcomes. The Benefits Counselor will be responsible for filling in at other AHS health centers as volume or extended absence of other staff dictates.
- Explain the benefits and eligibility standards for relevant insurance programs to Health Center patients, with a focus on Medical Assistance and the Children’s Health Insurance Program (CHIP). Will require basic working knowledge of Affordable Care Act program eligibility.
- Determine appropriate insurance program for the patient.
- Refer patients who qualify for Affordable Care Act coverage through the Health Insurance Marketplace to Insurance Specialist or Health Federation Navigator for assistance.
- Submit MA/CHIP enrollment forms via COMPASS to appropriate office/agency for processing on behalf of patient, ensuring inclusion of all necessary documentation, and follow-up with client and office/agency as needed.
- Work with insurance programs and staff to ensure proper and complete processing of application(s).
- Assist patients who are denied benefits with the appeal process as needed.
- Maintain accurate and complete logs, files and statistics of contacts, application statuses, and reasons for denial.
- Work closely with Health Center medical, nursing, and social work staff to assist patients in receipt of insurance benefits.
- Assist patients with other insurance-related tasks including HMO and PCP selections or changes, benefits questions, etc.
- Use Health Center electronic medical records to ensure thorough communication of patient’s eligibility and application status.
- May collaborate with PCCY, CLS and other community agencies in efforts to increase enrollment of health center patients.
- High School Diploma required. Some college or Bachelor’s Degree preferred.
- Prior knowledge of health insurance preferred. Experience working in public sector preferred.
- Excellent written and verbal skills (English). Second Language is a plus.
- Skilled in Microsoft Word and Excel. Experience with electronic health records a plus.
- Must have an original, current, valid and acceptable PA Child Abuse History Clearance, or obtain one within (2) months of hire.
- Must have valid driver’s license and automobile or access to public transit as the job requires local travel (attendance at quarterly meetings, staff trainings, etc.).
Position Type and Work Schedule
Full-time position. Hours 8am-4:30pm with a 60-minute lunch break Monday-Friday or 8am-4pm with 30-minute lunch break Monday-Friday.
The Health Federation reserves the right to modify, interpret, or apply this job description in any way the Company desires.The above statements are intended to describe the general nature and level of work being performed by an employee assigned to this position. This job description in no way implies that these are the only duties, including essential duties,responsibilities and/or skills to be performed by the employee occupying this position. This job description is not an employment contract, implied, or otherwise. The employment relationship remains “at will.” The aforementioned job requirements are subject to change to reasonably accommodate qualified disabled individuals.