Membership Specialist

MHC Healthcare; Hyde Park Township (IL); On-site; USD 35,000 - 55,000; Full time

Job summary

Join a forward-thinking community health center as a Membership Specialist, where your role is vital in ensuring new patients receive the behavioral health services they need. This position involves verifying patient eligibility, assisting with funding applications, and maintaining accurate records in an Electronic Medical Record system. You'll be part of a dedicated team committed to improving community health, ensuring that every patient receives the support and services they deserve. If you thrive in a dynamic environment and are passionate about making a difference in people's lives, this opportunity is perfect for you.

Benefits

Medical, Dental, and Vision

403(b) with employer contribution

Short-term disability

Paid time off including holidays

Paid bereavement and jury duty

Employee discount for medical services

Education reimbursement

Qualifications

• High School Diploma or GED is required for this role.
• Preferred financial experience in Behavioral Health or medical settings.

Responsibilities

• Enroll and verify eligibility of new patients for behavioral health services.
• Update and maintain accurate financial and insurance information in EMR.
• Assist patients with applications for funding sources.

Skills

Basic bookkeeping principles

Ability to work under stress

Multi-tasking

CPR and First Aid certification

Education

High School Diploma or GED

Tools

Electronic Medical Record (EMR)

Job description

Marana Main Health Center, Marana, Arizona, United States of America

Job Description

Posted Wednesday, June 19, 2024 at 9:00 AM | Expired Monday, July 29, 2024 at 8:59 AM

MHC Healthcare is seeking a Membership Specialist to join the utilization and membership team at the Marana Main Health Center, located in the heart of Marana, AZ.

The Membership Specialist is responsible for enrollment and eligibility of new patients in need of or interested in behavioral health services. This includes determining eligibility based on income or insurance status, assisting patients with applications for appropriate funding sources, verifying financial or insurance information and completing enrollment and referral entry into the Electronic Medical Record (EMR) and electronic systems of funding sources. The Specialist is also responsible for re-verifying, updating or providing continued patient support after enrollment to ensure financial and insurance information is accurate throughout the enrollment period of the patient. MHC Healthcare is a Federally Qualified Community Health Center (FQHC), with 17 sites in Tucson and Pima County. Our mission is to improve our Community by providing exceptional, whole-person healthcare.

The following qualifications are required:

• High School Diploma or GED

The following qualifications are preferred:

• Financial experience in Behavioral Health (BH) or medical setting preferred.
• Experience with Regional Behavioral Health Authority (RBHA) system and State AHCCCS behavioral health billing preferred.
• Fingerprint Clearance Card through the Arizona Department of Public Safety (or ability to obtain upon hire)

Equivalent combination of education and experience may be considered if applicable and must be directly related to the functions and body of knowledge required to successfully perform the job.

This position has the following supervisory responsibility:

• Does not direct or supervise others.

The ideal candidate will also possess the following knowledge, skills, and abilities:

• Knowledge of basic bookkeeping principles.
• Ability to work under stressful situations.
• Ability to multi-task.
• CPR and First Aid certified, if appropriate.

Duties and Responsibilities:

• Accepts calls from potential BH clients and ensures timely responses.
• Collects information related to patient eligibility, including assessing insurance and Sliding Fee Scale (SFS) eligibility.
• Schedules patients with new intake appointments based on patient eligibility and provider credentialing.
• Updates information in EMR for co-pay amounts, ongoing insurance verification and information regarding eligibility and enrollment collected from patient, insurance or payer sources.
• Regularly reviews and re-verifies insurance, SFS assessments and other financial information to ensure accuracy and certification.
• Notifies clinical staff and support staff when issues arise related to non-payment of charges, or change in eligibility or enrollment.
• Provides assistance and coaching to clinical and support staff to ensure accuracy of billing, payment collections and covered service provision.
• Participates in agency, community and RBHA financial meetings as required requested.
• Observes applicable state and federal laws.
• Assumes responsibility for knowledge of laws and requests clarification, if necessary.
• Maintains general BH and education standards and keeps abreast of BH and State RBHA guidelines by reading and attending in-services and workshops as appropriate and indicated in staff development plan.
• Follows professional and ethical practices when working with clients, client records, families and community personnel.
• Has a thorough knowledge of all MHC policies and procedures.
• Maintains confidentiality of client/family information.
• Uses appropriate incident reporting procedures when documenting unsafe or problematic incidents involving patients, clients and/or staff.
• Completes Incident Report accurately and follows procedures completely.
• Interacts effectively with staff, management, community members and other agency personnel to promote a milieu of trust, productivity and growth.
• Performs appropriate follow through from start to finish with all assigned tasks.
• Maintains professional and technical knowledge by attending educational workshops.
• Maintains a positive attitude towards job responsibilities working collaboratively with all MHC staff members to create a productive, working team.
• Utilizes appropriate channels for reporting/discussing/problems solving or concerns.
• Completes all other tasks as required.

MHC Healthcare’s vision is to be the premier provider and employer in community health. To support our mission and vision in our community, MHC Healthcare believes health and well-being must start at home. Therefore, employees have many opportunities to care for our own health and wellness with benefits such as:

• Medical, Dental, and Vision
• 403(b) with employer contribution
• Short-term disability and other benefits
• Paid time off including 11 holidays plus vacation and sick leave accrual
• Paid bereavement, jury duty, and community service time
• Employee discount for medical services ($500 per year for full-time)
• Education reimbursement ($3,000 per year for full-time)

MHC Healthcare will recruit, hire, train, and promote persons in all job titles without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law. In addition, all personnel actions such as compensation, promotion, demotion, benefits, transfers, staff reductions, terminations, reinstatement and rehire, company-sponsored training, education and tuition assistance, and social and recreational programs will be administered in accordance with the principles of equal employment opportunity.

Marana Main Health Center, Marana, Arizona, United States of America