Patient Benefits Counselor

Job Description

Job Description

Overview of the Position:

The Patient Benefit Counselor is the organization’s financial advocate assisting all HopeHealth patients with obtaining benefits to cover medical care, prescription drugs, outside referrals, etc. They are responsible for the collecting of data for all new patients and entering into practice management system for reporting purposes.

• High School Diploma or GED required. Associates degree in related field preferred
• 1-2 years of medical office or hospital experience, preferably in front office or financial counselor role.
• eClinicalWorks experience preferred
• Proficient with Microsoft Office Suite specifically Excel and Word

• Demonstrates the ability to work in a high pressure environment
• Strong active listening skills, attention to detail, and decision-making skills are required
• Pleasant, friendly attitude with the ability to adapt to change is essential
• Superior problem- solving abilities is required
• Ability to collaborate with all departments
• Ability to be flexible with changing priorities, work volume, procedures, and variety of tasks.
• Ability to communicate effectively utilizing both oral and written means.
• Ability to handle various tasks simultaneously while working efficiently, effectively, and independently
• Ability to show compassion to patients of all backgrounds and social status
• Must obtain and retain ability to utilize SC Thrive, ACA product, and other programs used to assist patients with benefits.
• Must pass an internal PBC Certification exam within three (3) attempts or six (6) months of acquiring position in order to retain position.

Supervisory Responsibilities:

• No supervisory responsibilities

• Meet with all new patients upon first visit to HopeHealth.
• Screen all new patients for interest in applying for benefits offered via the Annual Registration Form.
• Responsible for the review, input, and scanning of new patient paperwork.
• Input critical information into practice management system (PMS) including but not limited to: demographic, payer, patient responsibility (copay, coinsurance, deductible, and non-covered services), and additional reporting data.
• Use SC Thrive to determine if patient is eligible for benefits such as Medicaid, Affordable Care Act (ACA), Sliding Fee Discount Program (SFDP), and WellVista.
• Assist qualified patients with the proper documents needed for Medicaid, Sliding Fee Scale Discount program, Affordable Care Act, and WellVista applications.
• Verify eligibility and benefits of insured patient. Clearly explain so patient is aware of eligibility and benefits of their insurance policy and their responsibility.
• Navigate uninsured patients through the Affordable Care Act insurances during open enrollment if they do not qualify for Medicaid.
• Enter patient payer information into Pharmacy Benefit Manager (PBM) timely.
• Update the PMS and PBM as patient moves thru steps of the benefit process.
• Coordinates with other HopeHealth departments to assist patients with financial needs.
• Address actions on a daily basis. Contact the patient by phone to follow up on needed paperwork, answer patient questions, or other requested items.
• Other assigned duties.

Physical Requirements:

Must possess the ability to communicate in the dominant language of the geographic region. Must be able to lift 30 pounds. Vision and hearing corrected to within normal limits is required. Must have manual dexterity to key in data; utilize computer, grab, grip, hold, tear, cut, sort, and reach.