Benefits Coordinator

GENERAL SUMMARY/ OVERVIEW STATEMENT:

The Benefits Coordinator is responsible for supporting the benefit coordination for the patients seen in the ID outpatient practices. The incumbent must have a great understanding for patient insurance, benefits and resources, be able to gather, synthesize and present data, and have great organizational skills. We are committed to fostering, cultivating, and preserving a culture of diversity, equity and inclusion. This commitment applies to staff members at all levels as well as the patient populations we care for. The ID Division is looking to hire a Benefits Coordinator who demonstrates these same values to join our team.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Relevant activities include, but are not limited to the following:

• Benefits management for Infectious Disease Associates and the Sexual Health Clinic.
• Benefit navigation for PrEP (Pre-exposure prophylaxis).
• Enroll patients into HIV Drug Assistance Program (HDAP) and CHII (Comprehensive Health Insurance Initiative)
• Facilitate patient enrollment into insurance- i.e. Mass Health. Create a Mass Health Connector online user account to assist with specific payor and patient enrollment challenges.
• Collaborate with clinical care teams as well as social workers to assist patients in enrolling and renewing healthcare/medication programs.
• Maintain spreadsheet documenting status of all HDAP/CHII patients.
• Run and review weekly report of patient lists of insurance status of any new patients, or patients whose insurance status is changing, including Mass Health PCC, Commonwealth Care, and other insurances that are non-contracted .
• Assist new HIV referrals and enroll in accepted insurance programs.
• Understand No Surprise Billing as well participation payors and apply the necessary information for prior authorizations, appointment estimates and changes to insurance carriers when appropriate.
• Proactively identify additional resources for vulnerable patient populations including the SHINE (Serving the health needs of everyone), coupons and vouchers.
• Work with Pharmacy to ensure medically necessary medications are covered.
• Submit and track Ryan White Dental Program applications to the Boston Public Health Commission
• Attend weekly Leadership meetings and participate in ongoing and future projects as needed.

SKILLS & COMPETENCIES REQUIRED:

Professional knowledge of patient billing and insurance products

Time management

Analytic/critical thinking

Attention to detail

Discretion and confidentiality

Communication

Electronic Medical Records i.e. EPIC

Resourcefulness

Adaptability; resilience

Sense of humor

LICENSES, CERTIFICATIONS, and/or REGISTRATIONS:

Not Applicable

• Bachelor’s degree is required.
• Minimum of 3-5 years’ work experience in academic healthcare setting, medical group practice, billing and/or managed care setting preferred.

Massachusetts General Hospital is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. Applications from protected veterans and individuals with disabilities are strongly encouraged.