Why You’ll Love This Job
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:
- 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.
Type: Full Time (Hourly)
Job ID: 116213