Benefit Eligibility Specialist

UEW Health; Provo (UT); On-site; USD 42,981,000 - 51,577,000; Full time

Job summary

UEW Health in Provo, UT is seeking an entry-level Benefit Eligibility Specialist to guide clients through EEOICPA and RECA programs, manage medical records requests, and ensure HIPAA-compliant handling. You will coordinate with facilities and clients, enter data accurately in HubSpot, and collaborate with the Growth Department to deliver compassionate service.

The role emphasizes meticulous data management, clear communication, and proactive outreach to facilities and clients to keep cases

Qualifications

• Familiarity with EEOICPA/RECA programs or willingness to learn.
• Experience in medical records requests or healthcare administration preferred.
• Understanding of HIPAA privacy and PHI handling.
• Experience with HubSpot CRM or similar tools is a plus.
• Customer service experience, especially with medical facilities, is essential.
• Strong attention to detail and organization.
• Good communication and liaison skills, across facilities and clients.

Responsibilities

• Request, track, and review medical records to determine benefit eligibility.
• Maintain HIPAA privacy and security in all interactions and documentation.
• Manage faxing and document flow with facilities and representatives.
• Outreach to facilities and clients for status updates and information gathering.
• Explain EEOICPA/RECA processes and benefits to clients and representatives.
• Enter data accurately in HubSpot and related systems; log interactions.
• Build relationships with clients, facilities, case managers, and internal teams.
• Balance multiple open records and cases with high accuracy and organization.

Skills

EEOICPA/RECA familiarity

Medical records requests

HIPAA regulations

HubSpot CRM experience

Customer service experience

Attention to detail

Interpersonal communication

Microsoft Office

Tools

HubSpot CRM

CRM platforms

Job description

Overview

COMPANY:

We are people who care about people. Our company has a unique history and was founded by two grandchildren of a former Department of Energy worker. Their love and determination for their grandfather to havethe best quality care for thebest quality of life is what drives our company to provide care for the energy worker population.

POSITION SUMMARY:

The Benefit Eligibility Specialist serves as the primary liaison for clients navigating the intricacies of the Energy Employees Occupational Illness Compensation Program Act (EEOICPA) and the Radiation Exposure Compensation Act (RECA) programs. This role is central to requesting, tracking, and reviewing medical records in full compliance with HIPAA regulations, while maintaining consistent communication with medical facilities and clients. With a focus on detail, accuracy, and compassionate service, this entry-level role in the Growth Department provides unparalleled client assistance, fosters collaboration across teams, and ensures effective communication both internally and externally.

Responsibilities

• Medical Records Management:Request, track, and review medical records from facilities and providers to support client benefit eligibility determinations. Ensure all records requests and handling are conducted in strict accordance with HIPAA privacy and security regulations.
• HIPAA Compliance:Maintain a thorough understanding of HIPAA requirements as they apply to the handling, storage, transmission, and disclosure of protected health information (PHI). Ensure all client interactions and documentation adhere to applicable privacy standards.
• Fax & Document Management:Send, receive, and track faxes to and from medical facilities, authorized representatives, and other stakeholders. Maintain organized and accurate records of all outbound and inbound communications.
• Facility & Client Outreach:Conduct outbound calls to medical facilities to follow up on records requests, verify information, and resolve outstanding items. Communicate with clients and their authorized representatives to provide status updates and gather necessary information.
• Guidance and Liaison Role:Act as the primary point of guidance for clients concerning their medical-card benefits, ensuring they understand the nuances of the EEOICPA/RECA programs.
• Data Management & CRM:Ensure accurate data entry and maintain trackable records in HubSpot and other systems. Log all client interactions, records requests, and follow-up activity with precision and consistency.
• Relationship Building:Develop and foster strong relationships with clients, their authorized representatives, case managers, medical facility contacts, and internal teams to facilitate seamless communication and problem-solving.
• Detail Orientation & Organization:Manage multiple open records requests and client cases simultaneously, maintaining a high level of accuracy and organization throughout all stages of the process.
• Customer Service Excellence:Commit to outstanding customer service, striving for continuous improvement in client satisfaction.
• Clear Communication:Effectively explain processes and benefits to clients, their authorized representatives, and other stakeholders in a clear and professional manner.
• Follow-Up Management:Schedule and manage follow-up calls and tasks tailored to individualclientand facility needs to ensure timely resolution.
• Event Support:Offer virtual support and guidance during client assistance events.
• Professional Representation:Represent the company with professionalism, always prioritizing client needs and ensuring they find the support they seek.

Perform other duties as assigned.

OTHER DUTIES AND RESPONSIBILITIES:

This position may require traveling between locations in your personal vehicle.

SUPERVISORY RESPONSIBILITY:

This position has no supervisory responsibilities

Qualifications

PREFERRED QUALIFICATIONS:

• Familiarity with the EEOICPA/RECA programs or a willingness to undergo training is highly beneficial.
• Prior experience in medical records requests, healthcare administration, or a related field is strongly preferred.
• Working knowledge of HIPAA regulations and the handling of protected health information (PHI).
• Experience with HubSpot CRM or similar CRM platforms is a plus.
• Prior customer service experience is essential, with a preference for candidates experienced in telephone communication with medical facilities or healthcare providers.
• Exceptional attention to detail and strong organizational skills, with the ability to manage multiple tasks and prioritize effectively.
• Exceptional communication and interpersonal abilities, apt for liaison roles involving facilities, clients, and internal teams.
• Proficient in Microsoft Suite, fax systems, and CRM platforms.
• Commitment tomaintaining client confidentiality and privacy at all times

Pay Range

USD $15.00 - USD $18.00 /Hr.