Job Information
CommuniCare Health Services Corporate HR Benefits Specialist, Mobile in Morgantown, West Virginia
My Health is currently recruiting for an HR Benefits Specialist to support employees in all matters related to insurance benefits. This is a mobile position based in Morgantown, WV.
Estimated Pay: $65k-75k/annually.
We offer: Full, robust benefit package, 2 weeks vacation, paid sick days and holidays.
This position involves travel to all 41 of our West Virginia facilities, as well as pharmacy, and home health offices. Qualified candidates must have a car and a valid driver's license. We pay for mileage and expenses!
Qualifications:
Education: Minimum of Associate's Degree, with a Bachelor's Degree (in Human Resources or related field) preferred.
Experience: Minimum of 2 years working for a Healthcare Insurance Plan (Managed Care experience preferred). Proven experience and knowledge providing benefit advice to self-funded employee benefit plan members and conducting benefit educational meetings.
Knowledge/Skills/Abilities:
Knowledge of healthcare insurance industry in order to successfully coordinate case navigation and easily adapt to the requirements of the field.
Proficient computer skills to include navigating multiple systems (i.e PowerPoint, Excel, Outlook, Word, Virtual Meeting Platforms, Teams, and Healthcare applications).
Strong advocacy, organizational, and administrative skills necessary to formulate a resolution plan for several members at once without sacrificing attention and care for members.
Highly developed verbal and written communication skills to expedite and facilitate patient understanding of health needs while maintaining a high level of respect and confidentiality for the patient.
Superior time management and organization skills to maintain track of appointed needs of floating sites and stay on schedule.
Ability to successfully guide patients with compassion, and empathy while demonstrating a complete understanding of healthcare procedures and practices.
Excellent problem-solver dedicated to finding the best solution for the patients’ needs.
Strong research abilities that aid identifying resources related to each client’s specific life situation.
Initiative to improve their patients’ quality of life.
Compassionate with a genuine desire to help others when explaining options /resolutions to patients and suggesting different options for treatment.
MUST have reliable internet and router with continuous 50-100Mbps internet speed
MUST have dedicated, private, quiet distraction free area space for work only thereby meeting HIPPA standards
Job Responsibilities:
Serve as onsite liaison for Health plan education/questions, issues and concerns
Manage employee service requests and escalations with insurance
Assist with claims issues utilizing a variety of teaching methods, including 1:1 meetings, lectures, group activities, case studies, and online learning modules to convey information about health plan programs and financial implications of benefit choices
Assembling and distributing benefit summaries, benefit guides, and enrollment guides
Respond and handle onsite/offsite incoming electronic escalation submission of insurance issues
Assist employees with finding participating providers /facilities and expediting services/treatment
Identify appropriate options and services to support and empower the employee independent healthcare decision-making in support of the highest quality healthcare outcomes, available provider network, and internal/external programs or services.
Use holistic approach, consult, mentors collaborate and engage with onsite HR staff, Care Advocates/ team members/colleagues, supervisor, case managers, or other multidisciplinary team members to address employee needs efficiently and effectively meeting goals and objectives.
Identify and escalate quality of care issues through established channels
Serve as a point of contact for employee inquiries via phone, email, and in-person interactions
Ensure strict compliance with HIPAA and maintain the highest standards of patient confidentiality and trust.
Maintenance of excellent record-keeping
Documentation of issues/interventions/resolutions
Attending daily huddles and weekly staff meetings
Create weekly reports for leadership and support with eligibility/enrollment