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Why You’ll Love This Job

General Description:
Under the direct supervision of the Director of Health Benefits, the Health Insurance Premium & Cost Sharing Assistance coordinator position manages payment of premium and out-of-pocket costs assistance to eligible patients in accordance with prescribed policies, procedures, regulations, and standards.

Job Duties and Responsibilities

Specific Responsibilities of the Job:

  • Review insurance policies for individual patients to ensure coverage is current for premiums or out-of-pocket costs to be paid.
  • Maintain and review eligibility documentation required of patients on file before requesting payment for premiums and/ or out-of-pocket.
  • Reviews support documents submitted by patients to ensure they are complete and current.
  • Submits requests of payment and collects signed checks from Accounts Payable.
  • Mail checks with proper support documents to insurance carriers on behalf of the patients.
  • Designs a tracking system to report in a timely manner who has submitted a request for assistance, the status of the request, and actions taken.
  • Meets with patients to complete eligibility documentation.
  • Responds to patients’ communication in a timely manner to prioritize eligibility maintenance.
  • Prevent insurance coverage lapse and/or interruption of access to medical care and prescribed drugs.
  • Upload eligibility documentation and agency documents into document portal and EHR.
  • Assists patients in understanding insurance benefits and financial responsibilities before services are rendered. 
  • Manage patient’s health records to ensure that all required information is correct and complete in the Prism Health North Texas (PHNTX) system and information is available to provide services.   
  • Other duties as assigned.

Direct Reports: None.


Required Knowledge, Skills, and Abilities:
Job Requirements:

  • Proficiency in Excel, Word, and Outlook.
  • Demonstrated ability to handle multiple responsibilities to meet tight deadlines in a complex environment.
  • Must maintain current knowledge of regulations and laws related to the medical insurance industry.
  • Ability to make decisions related to appropriate client care.
  • Ability to effectively communicate in verbal and written formats.
  • Ability to establish effective working relationships with clients.
  • Ability to manage and work effectively in the required electronic medical record, database, or document portal.
  • Ability to work in a multi-site work environment.

Education and Experience:

  • Associate degree in accounting or related field with knowledge and experience in the insurance industry.
  • Bilingual in English/Spanish is preferred.

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Type: Full Time (Hourly)
Job ID: 116213