Benefits Assistant bei undefined

JOB SUMMARY

The Benefits Assistant plays a key role by providing front-line assistance to members and performing administrative tasks that ensure the effective operation of the prepaid sliding fee program.  This dual-function position is responsible for screening applicants, assisting with benefit eligibility and enrollment, maintaining accurate records and databases, and supporting internal staff and leadership through member communication and compliance efforts. The Benefits Assistant ensures high-quality service by managing inquiries, processing documentation and payments, and coordinating benefit-related programs.

ESSENTIAL JOB FUNCTIONS

1. Screens and interviews prospective members to determine program eligibility and benefit levels.
2. Clearly explains Family Health Center (FHC) benefits and outlines member responsibilities.
3. Assists individuals in identifying and enrolling in additional health coverage options and accessing available community resources.
4. Investigates primary insurance coverage to ensure accurate coordination of benefits.
5. Coordinates appointments, provides intake materials, and informs members of required documentation.
6. Greets and supports members in person, by phone, and electronically; triages inquiries to appropriate team members as needed.
7. Maintains accurate member databases for program tracking, reporting, and mailings.
8. Verifies and adjusts program fees based on reported member changes; conducts routine audits to confirm continued eligibility.
9. Advises members transitioning to Medicare or other programs (e.g., LIS, SeniorCare) and coordinates appropriate benefit changes.
10. Initiates payment reminders, negotiates payment arrangements, and processes program fee payments.
11. Submits income updates and issues revised member correspondence and ID cards.
12. Ensures all documentation is complete, accurate, and compliant with eligibility requirements.
13. Maintains regular on-site attendance to support program operations and member needs.
14. Provides backup support to the Patient Assistance Administrative Assistant, including processing incoming and outgoing mail and assisting with departmental ordering.
15. Perform other duties as assigned.

EDUCATION AND EXPERIENCE

1. Highschool Diploma or equivalent
2. Minimum of two years’ experience in a medical or business office, health insurance, public agency, or social program setting.
3. Demonstrated proficiency in customer service, including strong verbal, non-verbal, and written communication skills.
4. Excellent listening skills and the ability to respond to high-stress situations with professionalism and a positive attitude.
5. Proficient in Microsoft Office Suite (Word, Excel, Outlook, etc.).
6. Solid understanding of basic business math, including calculations and percentages.

CERTIFICATIONS / LICENSES

Certified Application Counselor (CAC) designation through the Centers for Medicare & Medicaid Services (CMS) within three months of the first CAC training period offered after hire.  Employees hired less than three months before the start of the training period may defer participation and certification until the following year.  

Note:  Employees are allowed a maximum of three attempts to pass the CAC exam within three months of completing the training.  Failure to achieve certification will result in termination from the position, unless an exception is granted due to extenuating circumstances.