Position Summary:

Under the general direction of the Patient Admission & Registration Supervisor, the Patient Benefits Coordinator primary purpose of the position is to identify patients who are eligible for Alternative Resources and serves as a liaison between the patient, hospital, and governmental agencies. This position requires the ability to work under conditions of frequent interruptions, be autonomous, collaborative and willingness to work a flexible schedule. Ensures applicable federal, state, local and organizational privacy laws and regulations are followed with issues related to Health information, confidentiality, release of information and patient rights. Assist uninsured individuals in determining their eligibility; facilitate the selection of and apply for a Qualified Health Plan or other public benefit programs; also provide education services and assist with Purchased Referred Care referrals.

This list of duties and responsibilities is illustrative only of the tasks performed by this position and is not all-inclusive.

Essential Duties and Responsibilities:

• Assist patients with determining eligibility for alternate resources. This may involve interviewing the patient at the hospital or at their home, helping complete online eligibility assessment tools and educating the patient about the availability of alternate resources.
• Serve as an advocate for the patient when the alternate resource makes an eligibility determination that is unfavorable to the patient and Sage Memorial Hospital by appealing an adverse decision when the facts warrant.
• Provide oversight through frequent follow-up with the patient and the alternate resource related to compliance with the requirements for establishing eligibility for the alternate resource’s assistance.
• Enter the approved alternate resources in the Meditech Expanse system in a prompt manner to ensure timely billing of services to the alternate resource.

• Work with the approved alternate resource to cover Sage Memorial Hospital services retroactively when the alternate resource regulations allow for that.
• Assist and collaborate with the Patient Access and Utilization Review departments by identifying the need for prior authorization if required by the alternate resource.
• May be called upon to assist with concurrent utilization review and discharge planning.

• Keep and maintain reports, databases, lists and spreadsheets as requested by management to organize work, provide management insights and ensure timely and accurate communication with patients and alternate resources.
• May be called upon to serve as a backup Admissions & Registration clerk at management’s discretion.
• Serve as a liaison between clinics and different healthcare benefits by improving communication and education to our patients.
• Assist individuals and families with alternate resource applications, to include but not limited to AHCCCS; KidsCare; Medicare; Medicare Cost Sharing Program; Medicare Prescription Plan; Freedom to Work; Long-term Care; Social Security Benefits; Arizona Breast & Cervical Care Treatment; Pregnant Women