Health Benefits Coordinator
Position Control #
Since 1976, Florida Community Health Centers, Inc. (FCHC) has been a health care leader in Florida. We provide comprehensive primary and specialty health care and patient support services through a network of Centers surrounding Lake Okeechobee and across Florida’s Treasure Coast. Our mission is to ensure that everyone in our communities has access to culturally competent, high-quality health care that they can afford. FCHC has locations in Clewiston, Moore Haven, Okeechobee, Fort Pierce, Port St. Lucie, Stuart, Indiantown, Pahokee and West Palm Beach. FCHC’s Corporate Office is centrally located in West Palm Beach, Florida. FCHC has multiple staff members who speak Spanish and Creole, and translation is available for other languages as needed. FCHC has created a “one-stop shop” for patients–providing Pediatric and Adult Primary Care, Dental, OB/GYN and Women’s Health, Infectious Disease, Behavioral Health, Pharmacy, chronic disease education and care management, referral assistance, benefit enrollment assistance and coordination, and telehealth services. Our patients benefit from a “medical home” model, where they may access our extensive array of health care clinicians and services in an atmosphere where they are treated with respect, care, and concern.
The Mission of Florida Community Health Centers, Inc. (FCHC) is to provide accessible, cost-effective, high-quality, comprehensive health care to all persons in our communities.
Florida Community Health Centers, Inc. (FCHC) will maintain strong leadership in, and advocate for, the provision of health care services.
FCHC will foster and promote collaborative relationships and will develop partnerships with local, state, and federal public health service agencies and the community in general, to enhance the quality of delivery systems for comprehensive health care. FCHC will be an employer of choice and will demonstrate excellence with a highly trained staff and governing board.
FCHC values Integrity, Compassion, Commitment to serving others (external and internal to the organization), Innovation, Effectiveness (cost and outcome), Efficiency, being Mission-driven, Commitment to serving others internal to organization and Commitment to Excellence.
Position Summary: The Health Benefit Coordinator (HBC) role is an essential program within Florida Community Health Centers (FCHC). We assist patients and others within our communities to apply for benefits that help to meet fundamental needs. This includes completing FL Medicaid, Food Stamp, Marketplace and Prescription Drug Applications. The person in this role must exemplify compassion, understanding and advocacy.
Role and Responsibilities:
- Completion of applications for state and federal programs (including Health Exchange/Marketplace programs and prescription drug assistance programs), reviewing medical records and taking all necessary action to expedite benefit approval.
- Interviewing patients in a community health center and hospital setting to assist the patients in obtaining maximum benefit coverage.
- Making a determination to complete a federal, state, local or pharmaceutical benefit application based upon medical definition of disability as it relates to body systems and to functions of daily living, and information contained in medical records.
- Monitors and fosters ongoing communications with government agencies regarding the status of applications.
- Effectively educates and answers inquiries from patients and family representatives regarding application process.
- Assists callers in resolving account issues by identifying and taking appropriate actions including completing required forms to support application process.
- Reviews inbox for daily work queues, identifies missing evidence and follows through to completion.
- Documents and updates internal database based on daily contact of select members of assigned applicant group and application evidence requirements, i.e. work activity, medical condition, third party, beneficiary, contact and demographic data financial, life and health insurance information, employment and salary verification, medical history and documentation where evidence is required.
- Assists patients with scheduling appointments and reminding of appointments, as needed.
- Complies with ethics, privacy and compliance policies and procedures.
- Assists with completion of prior authorizations alongside the pharmacy team
Skills and Abilities
- Must exemplify a professional demeanor.
- Possess empathy with the target population and must be culturally sensitive to all racial/ethnic groups.
- Ability to communicate effectively verbally and in writing in English.
- Ability to establish and maintain effective working relationships with others.
- Must be a self‐starter. Ability to work independent of constant supervision.
- Ability to prepare and maintain records and reports. Must be prepared to report suspected child or elderly abuse as well as suspected fraud to the appropriate authorities.
- Be computer literate.
- Be able to work with clients who may be unable to read, write and are unable to operate a computer.
- Must be able to prioritize work, and be flexible to changes at any moment.
- HIV education and prevention experience, a plus
- Ability to research available programs and benefits that will help our communities
Qualifications and Education Requirements:
Minimum Requirements (experience, training, and education): To effectively fulfill this position, candidate must meet the following requirements:
- High School Diploma or its equivalent
- College degree in related field of Social Services, Human Services or Healthcare, a plus
- Valid Florida Driver’s License and has reliable/accessible transportation.
- Bilingual Spanish/English, a plus
Training/certifications (can be gained post hire)
- HIV 501
- Certification as CAC
All qualified candidates must be able to perform the essential functions of this position. This job description is not intended to be all-inclusive. FCHC reserves the right to modify or change the essential functions of this position based on reasonable related business necessity as assigned by your supervisor.
**This job description does not constitute a written or implied contract of employment**.