Benefits Coordinator for Oregon Sisters and Billing Assistant

Location: Lake Oswego, OR
Date Posted: 08-01-2018
SUMMARY:  The Benefits Coordinator for Oregon Sisters and Billing Assistant has the responsibility for ensuring that all Oregon Sisters of the Holy Names of Jesus and Mary receive appropriate health insurance and public benefits, based on their individual needs and circumstances. This position, under the direction of the Province Director of Benefits, assists Sisters in accessing benefits and is responsible for maintaining current and accurate information following Province Health and Well-Being (HWB) Office Benefit guidelines.  This position also provides assistance to the Province Director of Benefits in processing payment of all health-related invoices and tracking of charges approved for payment.
 
 
ESSENTIAL DUTIES AND RESPONSIBILITIES:
 
  1. Under the direction of the Province Director of Benefits and in collaboration with the Oregon Clinical Care and Assistant Clinical Care Coordinators assesses individual Sister’s benefits and insurance coverage needs and assists Sisters in accessing their benefits.
  2. In consultation with CFO obtains accurate and current information on income and assets to determine eligibility for public benefits, health insurance and OHP coverage.
  3. Following application rules and deadlines completes applications, re-certifications and/or enrollments for:
    1. Social Security, Medicare, SSI, Medicaid and Medicare Savings Programs
    2. Medicare Advantage health plan or Medicare Supplemental plan
    3. Other health, dental and prescription plans as needed.
    4. Medicare Part D and Limited Income Subsidy (LIS).
  4. Following consultation with the Province Director of Benefits implements appropriate benefit changes and collaborates with Sisters to ensure timely enrollment to avoid coverage gaps or missed opportunities.
  5. Processes forms, enters updated information into the data base as assigned, and completes other documents to comply with application deadlines and eligibility.  Notifies insurers and benefit providers upon a Sister’s death or change of address.
  6. Tracks benefit applications, eligibility determinations, re-determinations, ineligibility issues and benefit terminations. Maintains complete and current records of each Sister’s health insurance and public benefits and enters information for each Sister into the Benefit Records of the Province database in a timely manner. 
  7. Reviews Oregon Sisters’ insurance and medical bills, and as needed, resolves related problems to assure insurance and public benefits have paid for all covered medical care, prescription, DME and related services.  Forwards requests for expenses not covered by insurance or public benefits to the Province Director of Benefits for payment from Province funds.
  8. Follows the guidelines and processes of the Health and Well Being department for  incoming billing invoices for the Charitable Trust fund:
  • Identifies invoices that are due for payment
  • Documents and tracks invoices per HWB document retention policy.
  • Notifies the Province Director of Benefits of invoice concerns, i.e., late, missing or error in the invoice.
  • Processes the bills to the appropriate shared drive folder as indicated, i.e., to California and Washington and each sister’s folder if indicated.
  • Files hard copy files to appropriate file and mails documents as indicated.
  1. Assists with Great Call products and systems.
  2. As needed assists with obtaining health related equipment and supplies.
  3. Attends weekly SNJM Oregon HWB care meetings. 
  4. Attends workshops and/or agency meetings, as requested by Province Director of Benefits to gain and/or maintain knowledge of federal, state, and local laws, codes and regulations as they pertain to government health insurance policies, etc.
  5. Other related duties as identified and/or assigned.
 
QUALIFICATIONS:  To perform this job successfully, individuals must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skills, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
 
Education:     Bachelor’s degree or a combination of post-secondary education and experience that will enable the employee to successfully fulfill the responsibilities of the position. 
 
Experience:    Required: One to two years’ experience in a healthcare environment.
                        Preferred: Experience coordinating general insurance and/or Medicare and Medicaid or other public benefits.
 
KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:
  • Must be supportive of the mission of the Sisters of the Holy Names of Jesus and Mary. 
  • Must model SNJM Guiding Values in carrying out work activities and responsibilities.
  • Must respect and maintain confidentiality of sensitive information.
  • Understanding of and ability to maintain appropriate professional boundaries.
  • Ability to work independently and also as part of a team; ability to analyze and prioritize work assignments and execute tasks in a timely manner.  Proven attention to detail and high degree of accuracy.
  • Ability to learn new and complex information about social, health and income benefits, and public entitlements.  Knowledge of medical terminology.
  • Ability to complete handwritten and online applications for benefit eligibility determination.  Must be able to read/comprehend cursive handwriting.
  • Demonstrated ability to communicate professionally, empathetically, and compassionately with elder population who may be ill, disabled, hospitalized, and/or experiencing loss.
  • Ability to maintain collaborative, professional relationships with SNJM Sisters, staff, and external contacts. 
  • High degree of flexibility and adaptability to shifting priorities and time constraints.
  • Proficient knowledge of Microsoft Office 2010 and other computer software programs including, but not limited to, Word, Excel, Outlook, and Internet Explorer.  Experience with electronic record keeping systems required.
  • Demonstrated written and verbal skills to assure effective communication.
  • Demonstrated ability to provide excellent customer service.
  • Ability to respond to emergencies appropriately and calmly as needed.
  • Valid drivers’ license.
 
PHYSICAL DEMANDS AND/OR WORK ENVIRONMENT: 
Performs primarily sedentary work in office/residential facility setting.  Occasional travel to trainings and meetings outside of local area.
 
HOURS: Full-time, 40 hours per week
 
EQUIPMENT USED:
Office computer, keyboard, mouse; office telephone/voice mail system, and web conferencing equipment.
 
The above description generally reflects the primary functions of the position.  The above statements shall not be construed as a detailed description of all the work requirements that may be required for the position.  Please note that the job duties outlined here are subject to periodic review and modification. 
 
SNJM is committed to continually building a workplace that exemplifies its values and vision of being hospitable to everyone.  The Sisters of the Holy Names of Jesus and Mary (SNJM) is an Equal Opportunity Employer.
 
To learn more about the mission and vision of the Sisters of the Holy Names visit: www.snjmusontario.org
 
To Apply: In order to be considered an applicant for this position, please complete our online employment application at https://snjm.catsone.com/careers.  Click “Apply Now” to complete and submit the online application.
 
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