Equal Opportunity Employer
The mission of the Health Federation of Philadelphia is to promote health equity for marginalized communities by advancing access to high-quality, integrated, and comprehensive health and human services. Health equity is at the heart of all our work. We believe in and are firmly committed to equal employment opportunity for employees and applicants. We do not discriminate on the basis of race, color, national or ethnic origin, ancestry, age, religion, disability, sex or gender, gender identity and/or expression, sexual orientation, military or veteran status. This commitment applies to all aspects of the Health Federation of Philadelphia’s employment practices, including recruiting, hiring, training, and promotion.
JOB SUMMARY
The Benefits Counselor will be knowledgeable about eligibility requirements and the benefit packages associated with health insurance coverage options available to Health Center patients. The Benefits Counselor will facilitate the assessment and subsequent enrollment of eligible uninsured patients. She/he will be expected to maintain daily logs, complete and submit reports on contacts, applications submitted, and outcomes. The Benefits Counselor will be responsible for filling in at other AHS health centers as volume or extended absence of other staff dictates.
JOB SPECIFICATIONS
Primary Responsibilities/Duties:
- Explain the benefits and eligibility standards for relevant insurance programs to Health Center patients, with a focus on Medical Assistance and the Children’s Health Insurance Program (CHIP). Will require basic working knowledge of Affordable Care Act program eligibility.
- Determine appropriate insurance program for the patient.
- Refer patients who qualify for Affordable Care Act coverage through the Health Insurance Marketplace to Insurance Specialist or Health Federation Navigator for assistance.
- Submit MA/CHIP enrollment forms via COMPASS to appropriate office/agency for processing on behalf of patient, ensuring inclusion of all necessary documentation, and follow-up with client and office/agency as needed.
- Work with insurance programs and staff to ensure proper and complete processing of application(s).
- Assist patients who are denied benefits with the appeal process as needed.
- Maintain accurate and complete logs, files and statistics of contacts, application statuses, and reasons for denial.
- Work closely with Health Center medical, nursing, and social work staff to assist patients in receipt of insurance benefits.
- Assist patients with other insurance-related tasks including HMO and PCP selections or changes, benefits questions, etc.
- Use Health Center electronic medical records to ensure thorough communication of patient’s eligibility and application status.
- May collaborate with PCCY, CLS and other community agencies in efforts to increase enrollment of health center patients.