Opening Date: March 25, 2025

Closing Date:  April 08, 2025

Job Title: Patient Benefits Specialists

Salary/Wage: $24.60/hr

Tribal Level 114

Location: Siletz, OR

Classification: Full-time, Non-Exempt

Job Posting Number:  2589451

INTRODUCTION:

The person in this position works with uninsured patients and community members to determine insurance eligibility. Assists in initial enrollment and renewal process to ensure continued coverage.  

DUTIES:

• Serves as key contact person for all tribal members and community members for OHP/Cover Oregon/ Federal Facility Market (FFM). Helps individuals understand and access affordable healthcare options.  
• Demonstrates and maintains expertise in eligibility and enrollment rules and procedures.
• Collaborates with staff to provide outreach.
• Assists patients in determining eligibility for the Oregon Health Plan/Cover Oregon/ FFM including application process, renewals, and appeals & grievances.  
• Explains benefits and services covered by insurances and Purchase Referred Care. 
• Connects patients with providers and resources in their area. 
• Acts as Patient liaison before OHP/Cover Oregon/FFM including processing urgent health coverage through Oregon Health Authority.
• Assists and answers patient concerns with explanation benefits (EOB's) and insurance denials.
• May also perform other duties as needed and assigned.

REQUIREMENTS:

Associates Degree in health administration area or related field - OR – an equivalent combination of specialized experience and/or education. Specialized experience is experience which is directly related to the position to be filled. 

Knowledge of:

Medical terminology.

Experience in:

• Working with MMIS, Word, Excel, and related computer applications.

Ability to:

• Become a certified Application Counselor/Assister in Oregon and Federal Marketplace. 
• Work with a wide variety of people and able to communicate effectively to tribal and community members, staff, insurance companies as well as federal, state and local health agencies.  
• Handle possible stressful situations involving explanation of insurance eligibility and benefits to patients with little or no knowledge of insurance practices.

Other:

• Must be well organized and able to handle a large volume of work.