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Copa Health · 1 day ago

Benefits Specialist

Glendale, AZ

Full-time

Onsite

Entry Level

$16/hr - $17.50/hr

2+ years exp

Copa Health is a healthcare organization seeking a Benefits Specialist. The role involves navigating and optimizing various benefit programs while assisting members with eligibility and enrollment processes, ensuring accurate patient information, and providing excellent customer service.

ChildrenHealth CareNon ProfitRehabilitationTherapeutics

Responsibilities

Verifies, ensures accuracy, and updates patient demographics and insurance information

Assist Office Assistants in the maintenance of accurate, up to date-to-date insurance verification

Use online web-based verification systems and reviews real-time eligibility responses to ensure the accuracy of insurance eligibility

Collects, verifies, and communicates necessary information with members' insurance carriers to obtain benefits and eligibility information

Complete, process, submit, and track prior authorizations

Initiates and assists patients with completing applications for Medicaid, Medicare, and SSI/SSDI

Screen persons to determine eligibility for Medicaid assistance and re-determine their continuing eligibility

Establish rapport and credibility with customers and providers by providing excellent customer service in a professional manner

Performs quality checks on all eligibility initiated and ensures there are process for all members who do not a valid, accurate, current insurance

Process eligibility case files within the required timeframes established by applicable funding source

Facilitate eligibility screening and ongoing monitoring

Process eligibility files into the company EHR/EPM system

Investigates and resolves denial cases of members who lose eligibility

Performs other administrative tasks to support the operations of the outpatient site

Adherence to all agency policies, licensure, and training requirements

To ensure compliance & adequate services, additional job duties may be required to meet the needs of the program and or department

Qualification

EHR/EMR systemsMedicaid/Medicare knowledgeInsurance verificationCustomer serviceTyping proficiencyProblem solvingTeamworkTime managementOrganizational skills

Required

High School Diploma/GED

Minimum of two years' experience in an office clerical setting

Must have a fingerprint clearance card issued by the AZ Department of Public Safety or eligible to receive on within eight (8) week of hire

TB Test clearance required at the time of hire and annually

Proficiency in typing, using computer software, i.e., EHR/EMR systems and MS Office

Ability to maintain confidentiality and adhere to all HIPAA regulations

Demonstrated ability to communicate, problem solve, and work effectively in an individual and team environment

Demonstrated ability to remain calm and use the proper de-escalation methods in crisis situations

Demonstrate an understanding of current Medicaid/Medicare/Marketplace information and systems

Ability to adhere to agency procedures, licensing and accreditation standards related to health and safety are maintained

Demonstrate superior work habits to include, but not limited to the following: time management, initiative, role modeling, leadership, organizational skills, and multitasking

Ability to work in a fast-paced environment