What are the responsibilities and job description for the Clinical Benefits Coordinator position at Ohio Gratings, Inc.?
SUMMARY: The Clinical Benefits Coordinator serves as a bridge between HR benefits administration and healthcare knowledge, providing associates with expert guidance on their health benefits, claims, and healthcare navigation. This role requires a strong understanding of medical terminology, insurance processes, and associate benefits. An ideal candidate will have experience in HR benefits administration, medical coding, nursing, or a related healthcare field.
ESSENTIAL DUTIES/RESPONSIBILITIES:
- Benefits Administration: Assist associates with benefits enrollment, changes, and inquiries. Provide guidance on plan options and help resolve benefits-related issues.
- Claims & Billing Support: Interpret Explanation of Benefits (EOBs), assist with claims disputes, and work with insurance providers to clarify coverage and costs.
- Healthcare Navigation: Help associates understand medical procedures, terminology, and coding as they relate to insurance coverage.
- Wellness & Education: Develop and communicate educational materials on benefits, preventive care, and wellness programs. Conduct informational sessions as needed.
- Medical Procedure Coordination: Assist associates in understanding coverage for medical procedures and help direct them in scheduling appointments in alignment with the company’s medical insurance plan.
- Compliance & Documentation: Ensure adherence to HIPAA, and maintain accurate and confidential associate records.
- Collaboration: Work closely with HR, benefits providers, and healthcare professionals to advocate for associates’ needs and optimize benefits utilization.
- HR Support: Assist the HR team with additional duties as needed, including associate relations, compliance, and general HR initiatives.
- All other duties as assigned. This job description is not all-inclusive or may not fully describe all responsibilities for this role.
EDUCATION, WORK EXPERIENCE, AND PROFICIENCIES: Experience in associate benefits administration, healthcare coordination, medical billing, or nursing or a related healthcare field. Strong knowledge of health insurance, coding, and healthcare billing processes. Excellent communication and problem-solving skills to assist associates with complex medical and insurance-related questions. Understanding and some proficiency in HRIS and benefits management systems is a plus. Ability to handle sensitive information with confidentiality and professionalism.
EEO STATEMENT: Our company provides equal employment opportunities to all applicants without regard to race, color, religion, gender, national origin, age, disability, veteran status, or any other characteristic or status protected under local, state, or federal laws.
