Health Benefits Assessor

**FNHA Overview**:
The First Nations Health Authority is a diverse and transformational health organization of professional, innovative and dedicated team members and leaders.

The first of its kind in Canada, FNHA works as a health-and-wellness partner with BC First Nations to support self-determination and decision-making to improve health outcomes.

**JOIN OUR HISTORIC JOURNEY**
At FNHA, you’ll have the opportunity to contribute to BC’s history. With a unique governing structure and mandate, our fluid work environment means you can play an active role in real change.
Our talented teams value respect and foster lateral kindness in their working relationships. Our holistic approach to wellness, based on First Nations teachings, is incorporated into all aspects of work culture. Where else will you get to create a personal wellness plan as part of your performance goals?

**Position Summary**:
The Health Benefits Assessor reviews, assesses, and adjudicates First Nations Health Benefits requests. Processes payments and client reimbursements. Conducts analysis and provides recommendations regarding exceptions and appeals. Provides program information to key stakeholders. This role maintains records and systems.

**As a health and wellness organization, the First Nations Health Authority has aligned with the Provincial Public Health Order released on October 14, 2021. We have a mandatory COVID-19 vaccination policy for all employees at First Nations Health Authority. This policy requires all employees to be fully vaccinated against COVID-19. If selected for employment, you will be required to provide proof of vaccination by providing a copy of your BC Vaccination Card Passport with the QR code.**

**Responsibilities**:

- Reviews, assesses, and adjudicates FNHA Health Benefit requests including prior approvals, amendments, post approvals, invoices, and client reimbursements. Screens request for completeness and accuracy. Clarifies and obtains required information, and explains requirements, procedures, rights, and obligations regarding claims and eligibility for benefits to clients, and stakeholders.
- Inputs adjudicated benefit decisions into an on-line Claims Processing system or alternate, including other related databases and spreadsheets. Performs patient, benefit, and cost verification to maintain integrity of client history in the databases.
- Provides FNHA Health Benefits information, advice, and assistance via telephone and/or written communication with First Nation clients, organizations, providers, prescribers, and other stakeholders relating to client and benefit eligibility, benefit criteria, prior approval, and appeal processes and payments.
- Maintains and updates databases, client files, and management and document control of electronic images and files.
- Maintains control accessibility of confidential client files and FNHA financial records to ensure privacy and security. Ensures client files are complete and includes documents such as specialist assessments, observations, research, recommendations, cost estimates and alternatives, and diagnoses. Research, extracts and compiles data and/or information to respond to client, supplier, health agency, and staff enquiries as required.
- A full job description is available upon request_

**Qualifications**:
**Education, Training and Experience**
- Grade 12, including completion of one year of post-secondary education, plus one (1) year of related experience, or an equivalent combination of education, training, and experience.

**Knowledge, Skills & Attributes**:
**Job Skills and Abilities**
- Knowledge of First Nations social, health, economic, and political issues
- Ability to provide information and advice directly to clients and providers.
- Conflict resolution skills.
- Time management skills.
- Knowledge of medical terminology
- Knowledge of data entry, manipulation, and retrieval techniques using a variety of automated systems and software.
- Physical ability to perform the duties of the position

**Closing Statement**:
**Diversity**

The First Nations Health Authority is committed to respecting diversity within our workforce; preference will be given to individuals with Indigenous ancestry (First Nations, Inuit, Métis).

**What You Can Expect From Us**

Joining our family means joining an organization that supports personal growth, in-house training, a paid volunteer day and a unique full-day orientation program.

Leading with culture, all FNHA employees complete San’yas Indigenous Cultural Safety Training. We support our family to be leaders in wellness and all staff members develop a yearly wellness plan as part of their performance partnership and goal-setting.

**Closing**

Please note that only those applicants shortlisted will be contacted. If you do not hear from us about this position, please accept our sincere appreciation for your interest in FNHA