Patient Benefit Services Coordinator

Job Description

Job Description

The Patient Benefit Services Coordinator serves as a liaison for uninsured and underinsured patients, providing eligibility and enrollment assistance for Medicaid, CHIP, and Federal Marketplace insurance programs. This role supports access to care through patient education, application assistance, and outreach activities, while connecting individuals to financial assistance programs and healthcare services within Hamilton Health Center and the community.

ESSENTIAL FUNCTIONS:· Provides fair, impartial, and accurate information regarding healthcare coverage options.· Assesses eligibility and assists with applications, renewals, and enrollment in programs such as Medicaid, CHIP, Medicare Part D, PACE/PACE NET, and Low-Income Subsidy programs.· Assists with completion of applications using the COMPASS system, including Medicaid, CHIP, and Presumptive Eligibility.· Educates patients and families on available insurance options, including low-cost coverage programs for children within the Commonwealth of Pennsylvania.· Maintains knowledge of eligibility requirements and program specifications for Medicaid, CHIP, and Qualified Health Plans (QHP).· Conducts in-reach, outreach, and education activities to promote awareness of available coverage options.· Represents Hamilton Health Center at community events as assigned.· Assists in developing marketing and promotional materials related to outreach and enrollment efforts.· Provides culturally and linguistically appropriate services, including language assistance and accessibility support for individuals with limited English proficiency or disabilities.· Refers individuals with questions or grievances to appropriate agencies, including consumer assistance programs and ombudsman services.· Ensures compliance with HIPAA and maintains confidentiality of all patient information.· Collects and analyzes data to support program reporting and continuous improvement efforts.· Prepares monthly reports and participates in required meetings, trainings, and conference calls.· Performs additional duties as assigned in support of departmental and organizational goals.
KNOWLEDGE, SKILLS, AND ABILITIES REQUIREMENTS:· Strong customer service skills with the ability to support diverse populations.· Excellent written and verbal communication skills.· Ability to analyze data and apply problem-solving skills effectively.· Strong organizational skills and ability to manage multiple tasks.· Ability to establish and maintain effective working relationships with staff, providers, and the public.· Ability to work effectively in a fast-paced environment.· Knowledge of and ability to engage with uninsured, underserved, and underrepresented populations.· Intermediate computer skills, including ability to type at least 40 words per minute.· Ability to work independently and complete projects with minimal supervision.· Demonstrates accountability, initiative, and teamwork.
MINIMUM EDUCATION & EXPERIENCE· Minimum of two (2) years of experience working with children and families in public health, outreach, social work, or a related field.· Experience with eligibility and enrollment processes preferred.
PREFERRED QUALIFICATIONS:· Working knowledge of Pennsylvania Medical Assistance programs, CHIP, and the COMPASS application system.· Experience with care coordination or care management in a healthcare setting.· Coursework or degree in Social Work, Public Health, Public Administration, or a related field.· Bilingual (Spanish) preferred.
EQUAL OPPORTUNITY EMPLOYER:Hamilton Health Clinic is an equal opportunity employer. We are committed to providing an inclusive and diverse work environment where all employees are valued, respected, and have the opportunity to succeed. We do not discriminate on the basis of race, color, religion, sex, national origin, age, disability, marital status, sexual orientation, gender identity, or any other protected status. All employment decisions are based on qualifications, merit, and business needs. LANGUAGE SKILLSAbility to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively with co-workers, internal and external customers, and outside contractors and vendors.
MATHEMATICAL SKILLSAbility to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
REASONING SKILLSAbility to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
PHYSICAL DEMANDS/MOTOR COORDINATIONRequires hand-eye coordination; finger dexterity, and a combination of sitting, standing, climbing, stooping, balancing, kneeling, reaching, carrying, pushing, pulling, lifting (up to 15 pounds). Must be able to write, type, use telephone and computer systems, and other office equipment. May require sitting or standing for long periods of time.
WORK ENVIRONMENTExposure to routine medical office/health clinic conditions as well as adverse environmental conditions such as dust, temperature and noise extremes, etc. May be exposed to infectious or contagious disease.
This job description is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with this position. While intended to be an accurate reflection of the current job, management reserves the right to review and change this description as needed to maintain business goals and accomplishments. Job descriptions are reviewed periodically. This job description is not a contract.