Provider Coordination and Benefits Specialist

Overview

Office and Mission: Join the Department of Health’s (DOH) Office of Infectious Disease (OID), where our mission is to protect and improve the health of all people in Washington State. Through programs like the Early Intervention Program (EIP) and the Pre-Exposure Prophylaxis Drug Assistance Program (PrEP DAP), we work to promote health equity, reduce new HIV infections, and address the social determinants of health for vulnerable populations, including those living with or at high risk for HIV. Our collaborative approach aims to create healthy communities, prevent illness, and ensure accessible healthcare for all.

 

Your Impact In this role, you will serve as a Provider Coordination and Benefits Specialist, a vital part of our mission to ensure access to necessary health services for clients enrolled in the EIP and PrEP DAP programs. Your work will directly impact clients by streamlining access to essential health services, reducing financial barriers, and coordinating complex healthcare needs. Through your dedication, you’ll contribute to better health outcomes and prevent new HIV infections across the state.

 

Key Responsibilities Include:

Coordinating medical, dental, and laboratory claims to provide seamless health coverage for clients.
Resolving eligibility and insurance conflicts for clients with multiple payers (Medicare, Medicaid, etc.).
Providing technical training and guidance to contracted providers, local health jurisdictions, and other partners to improve client access to care.
Addressing billing issues, ensuring timely provider payments, and supporting client services to eliminate access barriers.
Engaging in quality management initiatives, including policy documentation, compliance reviews, and annual audits.
Maintaining active communication with clients and partners to promote equitable healthcare access, with sensitivity to cultural diversity and various client backgrounds.