Bilingual Patient Benefits Specialist II - Administrative Office

Primary-Health-Care,-Inc.; Des Moines (IA); On-site; USD 39,000 - 49,000; Full time

Benefits offered by this job

Mileage reimbursement

Out of town travel bonus

Shift differential

401k with company match

Medical insurance

Dental insurance

Vision insurance

Job summary

Primary-Health-Care, Inc. is seeking a Patient Services Specialist II to ensure a positive, seamless experience for patients across PHC clinics. You will conduct financial screenings, assist with Medicaid/Marketplace enrollment, and support billing and financial assistance processes.

The role focuses on patient outreach, documentation, and collaboration with billing and clinic staff. It may require coverage at PHC clinics in Ames, Des Moines, and Marshalltown and travel reimbursement eligibility.

Qualifications

• High school diploma or equivalent.
• Two years of experience in healthcare, human services, or social services; or three years in customer service.
• Effective verbal and written English communication skills.
• Effective verbal and written Spanish communication skills.
• Professionalism and excellent customer service skills.
• Detail oriented with a high degree of accuracy.
• Problem-solving and critical thinking skills.
• Takes initiative and is dependable.
• Team oriented with the ability to work collaboratively.
• Basic math skills.
• Ability to understand and follow written instructions.
• Proficiency using Microsoft Office and Google Suite computer applications.
• Ability to learn and effectively use the electronic health record system.
• Organization, prioritization, and time management skills.
• Strong interpersonal skills with ability to establish and maintain effective working relationships with a diverse group of individuals.
• Completion of Presumptive Eligibility training and training completion award documentation are required within the introductory period.
• Licenses & Certifications: CAC certification required within 12 months of starting.

Responsibilities

• Ensures a consistent revenue cycle process by reviewing patient schedules for financial assistance or payment plans.
• Completes outreach to patients with past balances or uninsured to screen and determine next steps.
• Meets with patients to apply for Medicaid or Marketplace coverage and attends enrollment events.
• Helps patients apply for the sliding fee program.
• Maintains patient financial assistance files including electronic notes.
• Completes back-billing when insurance is identified or approved.
• Answers billing questions and collaborates with the billing department.
• Verifies and follows up on patient credits and refunds.
• Completes monthly laboratory and radiology billing.
• Communicates anticipated costs and creates good faith estimate letters under No Surprises Act.
• Monitors payer mix and reports to address unfavourable changes.
• Provides ongoing support to the Patient Access Representative role.
• Performs other duties as assigned.

Skills

Verbal English

Written English

Spanish proficiency

Customer service

Attention to detail

Problem solving

Teamwork

Education

High School diploma

Tools

Microsoft Office

Google Suite

Electronic Health Record (EHR)

Job description

As a Patient Services Specialist II, you will be responsible for ensuring a positive and seamless experience for patients and visitors within PHC medical and dental clinics. You will conduct financial screenings, assist with insurance enrollment (including Medicaid and Marketplace plans) and financial assistance programs, address billing questions, perform back-billing, monitor the payer mix, and support compliance. This role involves patient outreach, in-person support, and maintaining accurate documentation for financial assistance and billing. You will collaborate with billing and clinic staff to ensure timely and effective patient support. You may also provide support and coverage for the Patient Access Representatives.

In this position, you will work at PHC's Administrative Office focusing on patient outreach and Medicaid redeterminations. You will be scheduled 40 hours per week, Monday - Friday 8 AM - 4:30 PM or 5 PM. This position is eligible for our $5.00 per hour shift differential if you work a 3-hour shift either after 5 PM on weekdays or anytime on Saturdays. Our team members are occasionally needed to cover other shifts, which may include a Saturday morning, or to work at other PHC clinics in Ames, Des Moines, and Marshalltown. Mileage reimbursement and/or an out of town travel bonus may apply.

What You Will Do

• Ensures a consistent revenue cycle process in medical and dental clinics by reviewing patient schedules to identify patients with upcoming appointments who need assessment for financial assistance, other available benefits, or payment plans.

• Completes phone outreach to patients with past balances, expired insurance plans, needed documents for income verification or uninsured to screen and determine appropriate next steps for patients.

• Meets with patients as needed to help them apply for Medicaid (including Hawk-I), Marketplace coverage, or other insurance programs. Conducts outreach and enrollment activities including annual Marketplace enrollment events. May provide assistance at various locations, including PHC clinics, community agencies.

• Helps patients apply for the sliding fee program.

• Maintains patient financial assistance files including electronic notes in registration and/or financial note files.

• Completes necessary back-billing for applicable patients when insurance is identified or approved after the visit.

• Answers patients’ questions related to billing statements and collaborates with the billing department to support patients in resolving issues related to medical and/or dental bills.

• Verifies and follows-up on patient credits and/or refunds that are identified through patient question or account verification processes.

• Completes monthly laboratory and radiology billing.

• Communicates with patients about anticipated cost of visit, if applicable. Creates and distributes good faith estimate letters in accordance with the No Surprises Act and upon patient request.

• Monitors and reports on payer mix for their assigned clinic and works with Clinic Director to address unfavourable payer mix changes.

• Provides ongoing support and coverage to the Patient Access Representative role.

• Performs other duties as assigned.

Qualifications You Need

Required

• High school diploma or equivalent.

• Two years of experience in healthcare, human services, or social services; or three years in customer service.

• Effective verbal and written English communication skills.

• Effective verbal and written Spanish communication skills.

• Professionalism and excellent customer service skills.

• Detail oriented with a high degree of accuracy.

• Problem-solving and critical thinking skills.

• Takes initiative and is dependable.

• Team oriented with the ability to work collaboratively.

• Basic math skills.

• Ability to understand and follow written instructions.

• Proficiency using Microsoft Office and Google Suite computer applications.

• Ability to learn and effectively use the electronic health record system.

• Organization, prioritization, and time management skills.

• Strong interpersonal skills with ability to establish and maintain effective working relationships with a

• diverse group of individuals.

• Completion of Presumptive Eligibility training and training completion award documentation are required within the introductory period of the position and must be maintained throughout employment thereafter.

• Licenses & Certifications: Certified Application Counselor (CAC) certification is required within 12 months of starting in position.

Preferred

• Higher education degree in a related field.
• Senior Health Insurance Information Program (SHIIP) Counselor Certification.
• Work experience in a community health center, medical or dental clinic, or in the essential functions of the position.
• Knowledge of clinical terminology.
• Knowledge of health insurance eligibility requirements, enrollment processes, and insurance impacts on the revenue cycle.

We Take Care of Our People

Your related experience and skills determine your base pay. Our typical hiring range for this position is $18.65 - 23.35 per hour. Candidates with extensive related experience may be considered for additional compensation up to the pay range maximum. In addition to base pay, PHC offers a comprehensive benefits package, including:

• Generous PTO accrual

• Eightpaid holidays

• License/certification fee reimbursement*

• Paid time off for continuing education & continuing education reimbursement*

• Tuition reimbursement program

• 401k with company match

• Medical insurance

• Dental insurance

• Vision insurance

• Life & disability insurance

• Flexible spending & health savings accounts

• Supplemental accident & critical illness insurance

• Discounted pet insurance

• PHC Priderewards program

Visit https://phciowa.org/careers for a summary of PHC’s benefits.

*Applies to positions requiring clinical licensure or certification.

Grow Your Career with PHC

We take pride in offering development and growth opportunities to our team. Some of our training opportunities include Emerging Leaders, Dental Assitant Trainee Program, & Medical Assistant Trainee Program. In the last year, over 30% of our open positions were filled through promotions or transfers.

Join the PHC Community

| PHC Talent Community | Facebook | Instagram | LinkedIn | TikTok

Monday - Friday 8 AM - 4:30/5 PM
40 Hours Per Week