Benefits Educator - Part Time - Days

Position Summary:

The Benefits Educator is responsible for educating patients about their health insurance benefits and coverage to help them better understand their financial responsibility for healthcare services. This position serves as an educational resource, providing clear and accurate information regarding insurance plans, benefits, deductibles, copayments, coinsurance, out-of-pocket costs, referrals, and prior authorization requirements.

The Benefits Educator works closely with Patient Accounting, Patient Access, and other departments to improve the patient financial experience through education while supporting Crisp Regional Hospital's commitment to exceptional customer service.

Basic Qualifications:

• Education:
• High school diploma or GED required.
• Associate's degree in Healthcare Administration, Business, or a related field preferred.

Experience:

• Five years of experience in healthcare, patient accounting, patient access, insurance verification, customer service, or a related field preferred.
• Knowledge of health insurance terminology and benefit structures preferred.

• Licensure, Registrations & Certifications:

This job does not require a license, registrations or certifications

Essential Job Responsibilities:

• Educate patients on their health insurance benefits and coverage.
• Explain insurance terminology, including deductibles, copayments, coinsurance, out-of-pocket maximums, and benefit limitations.
• Review patient insurance benefits and explain expected financial responsibility based on available benefit information.
• Help patients understand how their insurance plan applies to hospital and physician services.
• Explain referral and prior authorization requirements when applicable.
• Answer patient questions regarding insurance coverage and benefits in a professional and compassionate manner.
• Provide educational materials and resources to help patients better understand their insurance coverage.
• Refer patients to the appropriate department for questions related to billing, financial assistance, payment plans, or insurance enrollment.
• Maintain accurate documentation of patient education provided.
• Protect patient confidentiality and comply with all HIPAA and hospital privacy policies.
• Maintain current knowledge of Medicare, Medicaid, Commercial, Medicare Advantage, and Marketplace insurance plans and benefit changes.
• Provide exceptional customer service while promoting a positive patient experience.
• Perform other related job duties as assigned.