Client Benefits Representative

The Client Benefits Representative provides financial counseling services including patient benefits, out of pocket responsibility, payment arrangements and financial assistance. Work as an advocate for patients and facilities as well as a liaison between operations and RCM by determining the eligibility of patients and clients for the various programs Mojave has to offer. Serves as a gatekeeper of the incoming and outgoing verification of benefits. Responsible for obtaining insurance benefits and verifying eligibility status. Handle requests and inquiries, maintain documentation, and support the clinic by ensuring the proper administration of Mojave’s different programs. You will also be responsible for collecting accurate demographic and insurance information for the revenue cycle data entry team.

• Obtaining insurance benefits, verifying of eligibility status, as well as their covered benefits and for confirming pre-authorizations for services in a timely manner; serve as a gatekeeper of the incoming and outgoing verification of benefits.
• Collects accurate demographic and insurance information for the revenue cycle data entry team; enters and updates patient demographics into the billing system as needed.
• Advocates for patients and facilities as well as a liaison between operations and RCM.
• Refer patients as appropriate to outside social services organizations. Assists patients and their families to apply for all possible programs for which they qualify, providing forms and assistance as needed; reviews documentation and follows up to ensure patients apply; resolves related problems. Obtain information and signatures on financial assistance program applications and route to appropriate teams in a timely manner for optimal financial turn-around.
• Meets with patients and their families to obtain information about their financial circumstances and informs them of the availability and eligibility requirements of various health programs (e.g., Medicare, Medicaid, commercial insurance, etc.). Educate patients and/or guarantors about their insurance coverage and benefits, including deductible, copay, coinsurance and estimated out of pocket costs.
• Determine patient financial ability to pay. Make determinations on financial assistance applications based on current Federal Poverty Levels and established policies.
• Provide financial counseling services regarding payment arrangements and financial assistance for uninsured and underinsured patients by phone or in person. Set up, maintain and edit payment arrangements on account when established.
• Handles high volume of inbound/outbound calls for patients that need to be screened financially and medically for financial resources. Answer patient calls and requests promptly and efficiently. Return all messages within 24 hours. Assist patient balance collectors with Inbound call volume
• Maintains high quality customer service while interacting with customers in person/via phone/email in a high volume environment and accurately document the encounter
• Properly documents all account activity in Patient Management and Electronic Medical Record systems. Scans and indexes records of patient financial eligibility, correspondence, and documents into EHR. Initiate and track all charity/financial care applications according to policy.
• Assist patients with questions regarding their accounts, insurance coverage and/or patient assistance needs in a skillful manner using appropriate etiquette
• Communicates with front office staff, clinical staff, and patient accounting regarding scheduling, patient treatment and financial counseling needs. Review patient account balances and notify front office staff of patients to meet with-(clients can meet with the PBR to go over payment plans or billing issues etc etc)
• Monitors and collects on all outstanding balances owed (when appropriate). Notifies billing of errors in charges, works with billing to adjust account charges.
• Runs daily schedule for those with commercial insurance to determine cost for time of visit
• Assists practice staff with eligibility, as necessary
• Functions effectively in a Matrix Management environment.
• Completes any duties and special assignments as requested.

• Minimum of two (2) years of experience in Authorization/Referrals, Financial Counselor, a high volume customer service role, and/or related field required
• Associate’s Degree in business or related field required
• Bachelors Degree in business or related field preferred

• Intermediate knowledge and experience in a medical office setting working with medical insurance, insurance verification, prior authorizations, coding and financial matters
• Knowledge and experience in financial counseling, including educating patients on their health insurance benefits
• Experience with a diverse patient population and showing sensitivity and empathy to patients and families experiencing complex medical situations
• Knowledge and understanding of federal or state government agencies including Social Security, Medicaid and/or Commercial coverages, familiar with the healthcare revenue cycle touching patient accounts
• Knowledge and experience working in a role that requires prioritization of multiple critical priorities while ensuring quality and achievements of performance metrics
• Knowledge of medical terminology, medical office procedures, and/or billing and diagnosis codes
• Demonstrated proficiency in Microsoft Office (Word, Excel, etc.) and Google Suite (Gmail, Docs, etc)
• Knowledge, skills and ability to work autonomously using specific software programs such electronic medical record (EMR) systems, insurance verification portals, and Microsoft Office applications
• Strong time management, critical thinking, and problem solving skills
• Excellent verbal and written communication skills
• Must be able to work independently with minimal supervision
• Must be able to multitask and prioritize work in a fast paced environment
• Must be able to maintain confidentiality and thorough knowledge of HIPAA policies and procedures
• Must be able to pay close attention to details and perform basic arithmetic and percentage calculations

• May include standing, sitting, and/or walking for extended periods
• May include performing repetitive tasks
• May include working on a special schedule (i.e. evenings and weekends)
• May include working with challenging patients and clients
• May include lifting up to 25 pounds

UNLV Health will provide equal opportunity employment to all employees and applicants for employment. No person shall be discriminated against in employment because of race, color, gender, age, national origin, ancestry, religion, physical or intellectual disability, marital status, parental status, sexual orientation, or any other category protected by law.

If you have any questions about our interview and hiring procedures, please contact Recruitment at healthjobs@medicine.unlv.edu.