Job Opening



Bulletin Number: FIN-VNPCC140300

POSITION Health Benefits Specialist I, II, III
SALARY GRADE 10, 11, 13
DIVISION Finance/Patient Accounts Management- Valley Native Primary Care Center
CLOSE DATE Open Until Filled


NATURE OF WORK:

The Health Benefits Specialist assists SCF achieve the goal of increasing the number of customer-owners enrolled with a third party payer.  

 

The Health Benefits Specialist role is to determine whether customer-owner currently has a third party payer, verify/confirm that third party payer information is current and correct. If not currently insured, the Health Benefits Specialist screens and evaluates whether customer-owner may qualify for any known payer sources, i.e. Medicaid, Medicare, Denali Kid Care, VA and/or the Federal Insurance Marketplace; and provides assistance to the customer-owner for the enrollment process.

 



KNOWLEDGE, SKILLS, AND ABILITIES:

Customer Care & Relationships:

  1. Creates, develops, and nurtures culturally appropriate interactions and connections with each other, customer-owners, and the community.

2.      Provides exceptional customer service.

·         Interacts with customer-owners in a friendly and courteous manner. 

·         Demonstrates the ability to work well with other departments and their staff.

·         Demonstrates ability to work well with government agencies.

·         Demonstrates ability to follow-up with government agencies.

  1. Develops and maintains successful working relationships with customer-owners, their families, colleagues, and others.

Communications & Teamwork:

  1. Shares and receives information, opinions, concerns, and feedback in a supportive manner.
  2. Works collaboratively by building bridges, and creating rapport with team members within departments and across the organization.
  3. Demonstrates effective written, oral, and interpersonal skills.
  4. Works effectively in a multi-disciplinary team environment.

Improvement & Innovation:

  1. Makes meaningful improvement to services, program, and processes and/or organizational effectiveness that creates new value for customer-owners and employees.

2.       Improves services, program, and processes and/or organizational effectiveness   that create new value for customer-owners and employees.

  1. Coordinates and leads small scale projects. 
  2. Actively participate in Team Projects such as Health Fairs/Outreach booths.
  3. Meets production and attendance standards.
  4. Uses improvement tools and principles.
  5. Uses the strategic planning and decision making processes.
  6. Works in a rapidly changing and innovative healthcare system.

Workforce Development Skills & Abilities:

1.      Seeks out additional learning opportunities to continue to develop the technical and professional skills needed now and in the future.

2.      Takes responsibility for all work activities and personal actions by following through on commitments.

3.       Completes a wide variety of administrative duties. 

·         Obtains and documents all necessary information required to provide services needed.

·         Completes all financial paperwork processes accurately and timely.  

·         Establishes and maintains an authorized system of administrative files.

·         Develops and monitors a system to track the status of various actions and correspondence.

4.      Completes a variety of computer-based tasks related to documentation in the appropriate format. Examples include but are not limited to:

·         Accurately entered payer information into appropriate systems for billing

·         Creates and maintains electronic database records as required.

·         Utilizes the intranet effectively. 

 

5.      Works with other agencies outside of Southcentral Foundation to secure patient enrollment in known third party payers. The most common payers are Medicaid, Denali Kid Care, Medicare, VA and the Federal Insurance Marketplace.

6.      Interviews and assists patient or responsible individual to complete application and apply for third party payer coverage.

7.      Monitors status from initiation to resolution and takes action to follow up if necessary. 

1.      Applies knowledge of Medicaid, Denali Kid Care, Medicare, VA and the Federal Insurance Marketplace application processes.

 

8.      Reviews, verifies, and confirms current third party payer information in EHR and billing systems.

9.      Applies knowledge of third party insurance, supplementary income, and social welfare programs.

10.  Applies knowledge of various health care resources available to patients, including Veterans Administration, Medicaid, Medicare, Handicap Children, the Federal Insurance Marketplace and private insurance.

11.  Applies skills and knowledge of screening and interviewing customer owners including ability to work with difficult individuals and complex situations

12.  Manages multiple responsibilities.

13.  Maintains quality, safety, and infection control standards. 

14.  Uses computers and appropriate software.

15.  Effectively and efficiently makes decisions independently.

16.  Performs job with minimal supervision.

17.  Applies knowledge with all applicable laws, policies, procedures, bylaws, regulatory requirements, and best practice guidelines regarding Privacy of Healthcare Information, Corporate and Healthcare Compliance. 

18.  Demonstrates problem-solving skills.

Additional responsibilities for Health Benefits Specialist II:  Meets all requirements of Health Benefits Specialist I in addition to the following:

 

Communications & Teamwork:

  1. Facilitates work team or groups.

Improvement & Innovation:

1.   Acts as a resource, mentor and trainer for entry-level Health Benefits Specialist personnel.

2.   Orients new Health Benefits Specialist staff to the department and to SCF systems and processes.

 

2.      Provides training to other employees.

 

3.      Responds to questions from others on standard procedure and best practices. 

 

Additional responsibilities for Health Benefits Specialist III: Meets all requirements of Health Benefits Specialist II in addition to the following:

 

Workforce Development Skills and Abilities:

1.  Applies skills and knowledge of screening and interviewing customer owners including ability to work with difficult individuals and complex situations.

 



QUALIFICATIONS:

SCF programs are established for the purpose of serving a primary population comprised of Alaska Natives who are affiliated with the Cook Inlet Region, Inc. (CIRI), and Alaska Natives and American Indians within SCF’s geographical service area.  All employees should have a thorough understanding of the cultures and the needs of the CIRI members, and of the general culture and needs of Alaska Natives and American Indians.  Such knowledge is critical in order to ensure the achievement of the mission and vision of SCF: working together with the Native community to provide the best services with Native staff who value the family and family wellness as the heart of the Native community.

  1. High school diploma or GED
  2. Three (3) years prior experience performing administrative and customer service duties with a minimum of one-year of experience performing revenue cycle duties which can include scheduling, registration, health information management, coding, billing, and/or collections experience; or demonstrated proficiency as an Administrative Support III with one-year of revenue cycle duties at Southcentral Foundation
  3. Certification as a State of Alaska - Certified Application Counselor (CAC) or obtain within 45 days of hire
  4. Maintain State of Alaska Certified Application Counselor certification 

 

Additional Qualifications for Health Benefits Specialist II:  Meets all requirements of Health Benefits Specialist I in addition to the following:

 

1.      One additional year as a Health Benefits Specialist, or demonstrated proficiency as a Health Benefits Specialist I at Southcentral Foundation.

  1. Certification as a Medicare Counselor

 

Additional Qualifications for: Health Benefits Specialist III.   Meets all requirements of   Health Benefits Specialist II in addition to the following:

 

1.      Two additional years of experience as a Health Benefits Specialist, or demonstrated proficiency as a Health Benefits Specialist II at Southcentral Foundation. 

2.       Completion of Department of Veterans Affairs-Tribal Veteran Representative training

 



INTERESTED APPLICATIONS:
Please complete an online application by clicking the 'Apply' button at the top/bottom of this page. For more information contact SCF Human Resources by Email or (907) 729-4977 or Toll free at 1-800-478-3343

NATIVE PREFERENCE UNDER P.L. 93-638.
Preference will not be given unless certification is submitted to Human Resources (a copy is acceptable).