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Enrollment Benefit Specialist

4 months ago


Wausau, Wisconsin, United States North Central Health Care Full time
Pay starting at $ $22.66 per hour.

Full-time 1.0 FTE (80 hours per pay period)

It is never too early to plan for retirement

-As an employee of NCHC, you would be eligible for the Wisconsin Retirement System (WRS), which is among the best funded and best managed public pension systems in the country.

-The WRS is a hybrid defined benefit plan. It contains elements of both a 401(k) or defined contribution plan and a defined benefit plan. The WRS is a strong public pension plan because of its stable funding, unique plan design and robust governance. These factors set the WRS apart from the vast majority of other plans in the United States. With some $142 billion in assets, it is the 8th largest U.S. public pension fund.

-Participating staff contribute 6.9% and NCHC will match this at 100% each pay period

Find a Realistic Job Preview online at

Purpose of the Position

The Enrollment Benefits Specialist shall be responsible for inpatient, outpatient and nursing home registration.

Education and Experience Requirements

Required:High school diploma or equivalent

One to three years experience in medical field

Preferred:Associate's degree in Health Care Business

Essential Duties and Responsibilities:
  • Interviews clients on initial appointment/walk-in. Collects data required for initial service request and to meet precertification and other third party requirements.
  • Contact third party for benefit verification; verifying information for precertification requirements in addition to any copayment amounts. Send out precertification packets if required.
  • Contact out of county board representatives to request new authorizations or update ongoing authorizations. Process OWI openings.
  • Upon new inpatient discharge, meet with client to discuss payment policies and procedures or mail inpatient discharge packet.
  • Completes preadmission benefit verification as requested by admissions coordinator, including benefits, precertification requirements and copayment amounts.
  • pon inpatient admission, meet with client/responsible party to collect required admitting data.
  • Review of daily outpatient appointments to verify accuracy of information on TIER; insurance information, authorization information, etc. Compare with outside eligibility systems, verify benefits and copayments for possible payments.
  • Ensure data entry of information into TIER as applicable for home, all outpatient and inpatient programs. Includes demographic, episode, financial and system update information.
  • Assist clients with application to financial aid programs, ensuring completion of application, follow up on a regular and timely basis, including nursing home annual reviews.
  • Maintain the Ability to Pay information. Communicate information to client, including letter to clients for updated information. Also responsible for periodic reviews.
  • Review Birth to Three client funding sources and authorizations monthly, comparing to previous month.
  • Verify online registration information entered by other departments for completeness and accuracy, updates
  • as needed, including adding to any subsequent system(s).
  • Maintains regular and predictable on-site attendance.
Other Responsibilities:
  • Perform other work related tasks as required as assigned
Competencies
  • Demonstrate organizational, leadership, management, clinical, department, program, common position and job specific competencies as required by North Central Health Care and/or various regulatory agencies based on job title.
  • Complete organizational, leadership, management, clinical, department, program, common position and job specific education as required by North Central Health Care and/or various regulatory agencies based on job title.
  • Qualifications and provision of care are in accordance with national acceptable standards of practices pertinent to role based on job title.
  • Knowledge of regulatory and accreditation standards along with federal, state and local codes pertinent to role based on job title.
Core Value Standards of Behavior

It is expected that all employees will demonstrate behaviors that support excellence as defined by North Central Health Care's Core Value Standards of Behavior.

Physical and Working Environment
  • Sedentary Work: Continuous sitting at desk, keyboard, etc. for several hours. Occasional lifting of under 10 pounds as required.
Physical Activities: List the minimum % of time required for each Physical/Mental Requirement.

Physical/Mental Requirements

90%

Climbing

X

Stooping

X

Kneeling

X

Crouching

X

Crawling

X

Turning or Twisting

X

Bending

X

Standing

X

Walking

X

Sitting

X

Carrying

X

Pushing

X

Pulling

X

Reaching

X

Grasping

X

Feeling

X

Data Interpretation

X

Decision Making

X

Verbal Communication

X

Verbal Comprehension

X

Written Communication

X

Written Comprehension

X

Problem Recognition

X

Problem Solving

X

Hearing

X

Near Visual Acuity

X

Far Visual Acuity

X

Depth Perception

X

Color Vision

X

Smelling

X

Repetitive Motions

X

Exposure to Hazards:
  • Minimal exposure to workplace hazards.
Working Conditions:
  • Indoors
Travel Requirements

Frequency: Minimal

Type of travel: Other

Nature of travel: Conferences only

Acknowledgement and Compliance

All requirements of the described position are subject to change over time where I may be required to perform other duties as requested by NCHC. Further, I acknowledge that this job description is neither an employment contract.

In compliance with the American with Disabilities Act, NCHC will provide reasonable accommodations to qualified individuals and encourages both prospective and current employees to discuss potential accommodations with the employer. North Central Health Care is an Equal Opportunity Employer.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR c)