Health Benefits Specialist I, II - $1,000 Sign-On

About Company:

Our Mission: We provide quality health care with competence, compassion, and sensitivity. We generously welcome you to join us in a place of unrivaled natural beauty, endless recreational opportunities, and a sustainable rural way of life. Bristol Bay Area Health Corporation (BBAHC) is a tribal health organization that represents 28 tribes throughout the region, which is approximately 35,000 square miles.

BBAHC is comprised of four subregions, each distinct in history, culture, natural resources, and community priorities. The regions include: Nushagak River & Bay Central, Southern, Western, and Kvichak Bay & North Side Peninsula. BBAHC manages the Bristol Bay Service Unit for the Indian Health Service and has done so since 1980. The main campus of the Bristol Bay Area Health Corporation is in Dillingham, which is located at the confluence of the Nushagak and Wood River systems and is a regional hub of the Bristol Bay salmon fishing district.

BBAHC operates the Kanakanak Hospital along with 21 Village Clinics, all of which are HRSA (Health Resources and Services Administration) Clinics. Clinical services include: Pharmacy, Medical Imaging, Laboratory, Dental, Optometry, Audiology, and Physical Therapy. The Kanakanak Campus also includes a residential treatment facility and a behavioral health counseling center. BBAHC is Joint Commission Accredited and upholds high standards for quality patient care.

About the Role:

The Health Benefits Specialist I, II plays a critical role in supporting the administration and management of health benefit programs within the healthcare and social assistance sector. This position is responsible for ensuring that eligible individuals receive accurate information and timely access to their health benefits, contributing to overall employee satisfaction and well-being. The specialist will collaborate with internal teams and external vendors to resolve benefit-related inquiries, process claims, and maintain compliance with regulatory requirements. By analyzing benefit plans and assisting with enrollment processes, the role helps optimize the delivery and utilization of health benefits. Ultimately, this position ensures that health benefits are effectively communicated and administered, supporting the organization's commitment to quality care and employee support. This position will be supervised by the Manager of Outreach & Enrollment.

Minimum Qualifications:

• High school diploma or equivalent; Associate's degree or higher preferred.
• Three (3) years prior experience performing administrative and customer service duties.
• One-year (1) experience performing duties in scheduling, registration, health information management, coding, and/or billing.
• Experience in benefits administration, customer service, or a related field within healthcare or social assistance.
• Basic knowledge of health insurance plans, terminology, and claims processing.
• Proficiency with computer systems and software applications relevant to benefits administration.
• Strong communication skills to effectively interact with employees, vendors, and internal teams.

Preferred Qualifications:

• Bachelor's degree in healthcare administration, human resources, or a related discipline.
• Certified Application Counselor (CAC) or obtain CAC within six (6) months of hire.
• Two (2) years of experience as a Level I Specialist; or demonstrated proficiency.
• Experience working with health insurance carriers and third-party administrators.
• Familiarity with federal and state regulations governing health benefits, such as HIPAA and ACA.
• Advanced skills in data analysis and reporting tools to support benefits program evaluation.

Responsibilities:

• Assists patients with inquiries related to health benefit plans, coverage details, and claims processing.
• Process enrollment, changes, and terminations in health benefit programs accurately and within established timelines.
• Collaborate with insurance carriers, third-party administrators, and internal departments to resolve benefit issues and discrepancies.
• Maintain up-to-date knowledge of health benefit policies, regulations, and compliance requirements to ensure accurate information dissemination.
• Prepare and maintain detailed records and reports related to health benefits administration and utilization.
• Support open enrollment activities by providing guidance and educational materials to patients.
• Identify opportunities for process improvements to enhance the efficiency and effectiveness of health benefits administration.
• Screens and interviews patients to determine eligibility for alternate health resources (AHR) such as Medicaid, Denali Kid Care, Medicare, VA, Tribally Sponsored Health Insurance (TSHIP), HRSA/Sliding Fee discounts, or other health programs.

Skills:

The Health Benefits Specialist utilizes strong communication skills daily to provide clear and empathetic assistance to patients navigating their health benefits. Analytical skills are essential for reviewing benefit plans, processing claims, and identifying discrepancies or opportunities for improvement. Proficiency with benefits administration software and databases enables efficient management of enrollment and claims data. Knowledge of regulatory requirements ensures compliance and accurate dissemination of information. Additionally, collaboration and problem-solving skills are applied regularly to coordinate with vendors and internal teams, ensuring seamless benefits delivery and resolution of issues.