LEAD PATIENT BENEFITS COORDINATOR

NAVAJO HEALTH FOUNDATION - SAGE MEMORIAL HOSPITAL, INC.•Ganado, AZ

1d•Onsite

About The Position

Under the direction of the Admissions & Patient Registration Supervisor, the Lead Patient Benefits Coordinator serves as a liaison between patients, Sage Memorial Hospital, and governmental agencies to support timely eligibility determinations and enrollment in alternate resources. The role provides daily leadership and operational oversight for the Patient Benefits team and supports front-end revenue cycle functions. The coordinator collects demographic and insurance information, registers patients, identifies and assists patients who may qualify for alternate resources, facilitates enrollment, advocates for access to available programs, and helps address additional social service needs. The position requires autonomy, collaboration, flexibility, and the ability to work effectively amid frequent interruptions while complying with applicable privacy regulations. The coordinator guides staff, helps manage workflow and workload, supports orientation and training, monitors work quality and compliance, and escalates personnel, policy, and operational matters to the supervisor as appropriate. The role assists patients with a range of public, tribal, and private benefit programs, follows up with patients and agencies, enters approved alternate resources into Meditech Expanse, and maintains records and tracking systems. The coordinator collaborates with hospital departments and outside agencies on coverage, authorization, billing, and coordination-of-benefits issues, and participates in community outreach and education. Work is primarily in an office, with occasional outreach, home visits, and community events. Extended hours, irregular shifts, travel, and scheduling flexibility may be required.

Requirements

High School Diploma or General Education Diploma (GED).
Two to three years of experience in a healthcare setting (hospital preferred) or with the Arizona Department of Economic Security processing AHCCCS/Arizona Medicaid applications.
Experience in patient benefits, patient registration, revenue cycle, or related healthcare functions.
Ability to speak the Navajo language and familiarity with the Navajo Way.
Successfully pass all Employee Health Program requirements and a background investigation.
Knowledge of Medicare, Medicaid/AHCCCS, Purchased Referred Care (PRC), Affordable Care Act (ACA), VA Healthcare, and other alternate resource programs.
Ability to interpret federal, state, Tribal, and third-party payer regulations.
Strong interviewing, communication, and customer service skills.
Ability to work independently, manage multiple priorities, and maintain professionalism under frequent interruptions.
Skill in maintaining confidentiality and complying with HIPAA and Privacy Act requirements.
Proficiency with computer systems, including Meditech Expanse, spreadsheets, and databases.
Ability to collaborate effectively with internal departments and external agencies.
Ability to sit for prolonged periods, run errands between departments, and occasionally lift and/or move objects weighing up to 25 pounds.

Nice To Haves

Leadership or supervisory experience to support team oversight and departmental operations.
Experience in a hospital setting.

Responsibilities

Provide day-to-day operational oversight of Patient Benefits workflow and offer peer guidance and support to staff.
Maintain current procedures, written processes, and training materials as directed by the supervisor.
Guide orientation and training for new and existing staff using supervisor-approved materials and departmental standards; report competency or accountability concerns to the supervisor.
Assign, balance, and monitor daily workload; track progress, identify barriers, and review work for accuracy and compliance.
Evaluate work quality and adherence to standards, return work for correction when needed, and refer complex or unresolved issues and backlogs to the supervisor.
Track staff performance, training needs, conduct, and behavior, and elevate concerns to the supervisor.
Arrange short-term or emergency coverage and address routine staff questions; elevate leave approvals, employment decisions, and complex matters to the supervisor.
Support the supervisor in reviewing and drafting departmental policies and procedures.
Prepare proposed staffing schedules and coverage plans for supervisor review and approval; track annual mandatory training completion and report exceptions.
Participate in departmental meetings and facilitate in-service training and educational opportunities as assigned or approved.
Support hospital planning and incorporate the hospital’s mission into daily departmental activities.
Interview patients in the hospital, at home, or by phone to determine alternate-resource eligibility; assist with applications, documentation, and online eligibility tools.
Assist patients with eligibility for AHCCCS/Medicaid, KidsCare, Medicare, VA Healthcare, Workers’ Compensation, Third Party Liability, Marketplace plans, Tribal programs, and other payors.
Appeal adverse eligibility determinations when appropriate and advocate for fair access to benefits.
Follow up with patients, families, and agencies to ensure program compliance and timely enrollment.
Enter approved alternate resources into Meditech Expanse promptly to support billing and secure retroactive coverage when allowed.
Comply with HIPAA, the Privacy Act, The Joint Commission standards, and applicable federal, state, tribal, and organizational rules concerning confidentiality, patient rights, and release of information.
Maintain accurate records, tracking systems, reports, spreadsheets, and databases.
Collaborate with Patient Registration, Utilization Review, PRC, Social Services, and Revenue Cycle to resolve coverage issues, prior authorization needs, billing discrepancies, and coordination of benefits.
Assist patients with Medicaid, Medicare, and private insurance Coordination of Benefits.
Liaise between clinics and benefit programs to improve communication, education, and patient understanding.
Support Purchased Referred Care referrals and assist with concurrent utilization review or discharge planning when requested.
Estimate and report expected completion times and maintain records of work accomplishments and time expended.
Recommend and implement cost-containment strategies.
Conduct community outreach and education at health fairs, chapter houses, schools, local events, and other community settings.
Serve as a backup Admissions & Registration Clerk at management’s discretion.
Perform additional duties, special projects, or assignments as needed.