POSITION SUMMARY

Assists with all aspects of Patient Financial functions, revenue cycle training development, outreach and enrollment and collections. The position will assist in effective training of revenue cycle activities across the organization to include, but not limited to front desk, billing issues, oversight of financial counseling and collections for patients, outreach and enrollment and staff training.

REPORTING RELATIONSHIPS

The position reports to Director of Patient Financials, Training and Quality Improvement. Outreach/Enrollment, Front Desk staff, and Community Healthcare workers work closely with this position. This position has no direct reports.

ESSENTIAL JOB DUTIES AND FUNCTIONS

Training

• Provides guidance and council regarding the Affordable Care Act and Health Benefit Exchanges to The Wright Center for Community Health staff
• Assists with of Front Desk Staff training and materials on insurances, verification, eligibility, and sliding fee application. It will be required that you work with staff at each clinic a minimum of one day per month. More days may be required. This will include education of community health workers as necessary
• Maintain knowledge and expertise in eligibility, enrollment, and program specifications of the Federal Marketplace and other health coverage programs such as Medicaid, CHIP and Medicare
• Assist with Daily Billing Summary Quality Control report as needed. Ensure patient registration information is accurate
• Assist in development of trainings to ensure proper co-pay collection at the level of the front desk
• Other duties as assigned

Outreach and Enrollment

• Conduct outreach and education activities to educate health center patients about insurance affordability through the Marketplace, Medicaid, Medicare and or CHIP to encourage participation
• Assist with Medicaid and Pennie Market Place applications for our Self-Pay patients
• Participate in Pennie State market place and other required training for Navigator certification and to enhance outreach and enrollment expertise
• Provide data and other information necessary for Pennie State market place and other reporting requirements
• Assist with the development and dissemination of marketing and promotional materials for outreach, application assistance and education activities that are tailored to the health center service delivery area and target population
• Process Sliding Fee applications
• Deliver the highest quality medical customer service to all parties involved
• Assist with Coordination of Benefit rejections and other rejections that pertain directly to the patients
• Other duties as assigned

QUALIFICATIONS

• Bachelor’s Degree in Business Administration, Public Health or closely related field with knowledge of health care project management OR equivalent combination of education and experience
• Must have at least 5 years previous experience in healthcare setting; preferably involving state and federal health care program
• Demonstrates ability to apply to develop effective working relationships with a variety of individuals to gain support and interest in program’s objectives
• Demonstrates ability to apply knowledge of a variety of federal, state and local resources, programs and services involved with Outreach and Enrollment initiatives
• Demonstrated ability to work independently with little direct supervision in the efficient and thorough completion of tasks
• Demonstrated ability to prioritize multiple tasks, assignments and projects to meet established quality and time requirements
• Demonstrated ability to work in a team environment
• Experience with insurance commercial, Medicaid, Medicare preferred
• Excellent verbal and written communication skills
• Proficient in Excel and Word skills

PACE CARD METRICS

• Monthly attendance of PACHC Navigator Project Meetings
• 10 Medicaid applications per month.
• 5 Marketplace Applications per month.
• All training for prior month reviewed with manager and adjustment for upcoming month.
• Monthly Training with front desk operations/revenue cycle activities and Community Health care Workers.
• Maintenance of online portal as insurances change, are removed, added or modified.
• Address training as necessary for individuals who have a high error number with insurance.

**Covid-19 Vaccination Required**