Benefits Specialist (Georgetown, TX) - Lone Star Circle of Care

Overview

The Benefit Specialist will facilitate consumer enrollment in insurance coverage in health care safety net programs such as Medicaid, CHIP, SNAP, and County Indigent programs. The Benefit Specialist may also facilitate consumer enrollment in insurance coverage through the federal Health Insurance Marketplace. The Benefit Specialist will screen individuals and families to determine eligibility for benefits and assist them in completing the application and enrollment process to obtain health care coverage. The Benefit Specialist may provide telephonic and in person program registration services for new and returning LSCC patients.  

Responsibilities

Provides application assistance and facilitates enrollment of eligible patients, individuals, and families in health insurance coverage and health care safety net programs.

• Provides non-biased information regarding available coverage options and benefits
• Fills out or helps to fill out appropriate applications
• Assists in identifying and gathering appropriate documentation to accompany the application submission
• Follows-up to ensure external program application process is completed
• Verifies documents and information gathered telephonically by Program Advisors when patient presents for face-to-face appointment
• Provides assistance in a culturally/linguistically appropriate manner

Provides accurate and timely program registration for new and returning LSCC patients.

• Receives scheduled and unscheduled calls through Patient Navigation Center and face-to-face encounters at clinical and other settings to conduct various Program Registration functions
• Performs program registration thoroughly to ensure highly accurate screening and enrollment outcomes for the federal Health Insurance Marketplace, health care safety net programs, and LSCC Sliding Fee Scale assignment
• Allocates appropriate time to each call/encounter to ensure high degree of patient/community member completion and kept appointments, while maintaining work flow
• Makes outbound calls as appropriate to perform program registration, case follow-up or to schedule additional program registration appointments
• Collaborates with front office staff member to ensure program registration policy and procedures are followed and to ensure clear and effective communication to maintain patient flow through the program registration process.
• Accurately identifies programs for which patient may be eligible

Completes all documentation in a timely, accurate and professional manner.

• Using Medicaider, NextGen, Mend, available insurance verification programs and other automated tools, maintains all patient documentation necessary to complete assignments and certify clients/patients in the appropriate programs.
• Completes case documentation electronically and maintains no paper files on cases
• Maintains appropriate electronic flags for timely follow-up with patients
• Ensures documentation sufficient to ensure coordination of care and program follow-up

Completes required training to perform accurate application enrollment assistance

• Acquires and maintains knowledge and expertise in eligibility, enrollment, and program specifications of the federal Marketplace and other programs such as Medicaid and CHIP
• Attends all required training to provide screening and enrollment assistance
• Obtains training certifications as applicable 

Qualifications

REQUIRED EXPERIENCE, EDUCATION, AND LICENSE:

• High school diploma or GED

PREFERRED EXPERIENCE, EDUCATION, AND LICENSE:

• Minimum of one (1) year experience working in the health care field
• Minimum of two (2) years’ experience in program eligibility or related health and human-services work
• Medical program application completion and enrollment experience
• Bilingual English/Spanish language skills are a definite plus