Citizens Healthcare Benefits Clerk

Gun Lake Tribe•Wayland Township, MI

5h•Onsite

About The Position

The Citizens Healthcare Benefits (CHB) Clerk will be responsible for assisting in the administrative support for the Citizen Healthcare Benefits Programs including insurance plans, Purchased Referred Care (PRC) and Extended Health Services (EHS). The CHB Clerk must be able to meet Federal Guidelines for insurance benefits, the PRC program and policy and procedures for the EHS program. This position will also be responsible for the maintenance and education of the programs to Tribal Citizens.

Requirements

High school diploma or GED
Experience working with Tribal health programs
Experience in customer service and telephone etiquette
Experience with electronic medical records and data entry
One year of office experience in a medical office setting with a demonstrated ability to understand and interpret vendor invoices, statements, insurance EOB’s and other requests for payment
Efficient in operating Microsoft office software and have general computer knowledge and skills
Ability to understand and interpret vendor invoices, statements, insurance EOB’s and other requests for payment
Experience in accounts payable
Knowledge and understanding of Public Law 93-638 of the Indian Self Determination Act
Experience working with Native American populations
Possess excellent written and verbal communication skills as demonstrated by being able to correspond with individuals throughout all levels of government and intergovernmental organizations
Must have good public relations skills including being patient, courteous and reliable
Must be highly organized and flexible, with the ability to multi-task and work independently
Ability to operate postage, fax and copy machines
Maintain the highest level of confidentiality of all matters
Able to maintain an effective teamwork relationship with co-workers

Nice To Haves

RPMS preferred

Responsibilities

Maintain strict confidentiality at all times and comply with Federal Privacy Act regulations as specified by IHS contract to protect the confidentiality of all clients; this will include any and all information pertaining to clients, while also assuring that federal HIPPA laws are upheld at all times
Collects, evaluates and logs all incoming/outgoing mail, in accordance with established procedures
Answer telephone calls for the PRC and EHS Program and respond to questions from Gun Lake Tribal Citizens and/or PRC and EHS vendors for prompt processing of claims
Verifies Tribal Citizens, residency and eligibility for insurance benefits, PRC and EHS
Register Tribal Citizens with the appropriate insurance benefits, PRC and EHS programs, which may include scanning, faxing, copying documents and maintaining files electronically and physically
Enter pertinent information and file all paid purchase orders for health services into clients’ files and into the RPMS (IHS) required federal data system
Refer and help Tribal Citizens with alternate resources for which they may be eligible and assist with paperwork and appointments as needed
Works closely with other resources (e.g. Medicare, Medicaid and private insurance etc.) on identifying coverage for Tribal Citizens
Able to assist the front desk as assigned to maintain appropriate office coverage
Assists with patient registration activities as assigned
Assists with data for program eligibility and compliance reports as assigned
Will adhere to the Purchased and Referred Care policy and procedure manual
Use tact and courtesy when dealing with clients, vendors and other agencies
Assist in all other projects and activities as assigned

Benefits

Medical, dental, vision and telehealth coverage for employee and all dependents, with no employee premium!
Paid Time Off and 15 paid Holidays
Short- and long-term disability coverage
Life insurance for the employee, spouse and their dependents
Pension plan for Public Safety employees
401K/Roth retirement plan with employer matching contributions
Employee Assistance Program
Employee Wellness Program
Voluntary Benefits: AFLAC and Flexible Spending Account, additional life insurance
On-site gym, free memberships for entire household
One-hour paid lunch break