Patient Benefits Coordinator I

Washoe Tribe of Nevada and California•Gardnerville Ranchos, NV

2d•Onsite

About The Position

Under direct supervision, the Patient Benefits Coordinator I is responsible for providing leadership and advocacy on behalf of patients by assisting in the obtaining of approval and utilization of benefit programs and alternative resources in coordination with the policies of Tribal Health. Maintains HIPAA confidentiality of all privileged information.

Requirements

High School Diploma or GED and two years experience in a medical office setting; or equivalent combination of education and experience.
Knowledge of records management and basic accounting procedures.
Knowledge of medical/dental terminology preferred.
Knowledge of Medicare, Medicaid, Social Security, federal health care legislation including Champus and the Indian Health Care Improvement Act provisions.
Ability to communicate effectively in the English language both verbally and in writing.
Ability to establish and maintain professional relationships with individuals of varying social and cultural backgrounds and with co-workers at all levels.
Ability to represent the organization professionally, building respect and confidence.
Ability to maintain confidentiality.
Ability to handle multiple tasks and meet deadlines.
Ability to carry out instructions furnished in verbal or written format.
Ability to work independently with minimal supervision.
Skill in operating business computers and office machines, in a MS Office environment, specifically Word, Excel, Access, and presentation software (such as PowerPoint).
Knowledge of EHR systems (NextGen, Epic, tc.).

Nice To Haves

Preference will be given to Qualified Native Americans.

Responsibilities

Determines patient eligibility for Direct Care and/or Purchased Referred Care.
Identifies patients who have or are potentially eligible for alternate resources.
Assures maximum identification by implementing effective screenings and interviewing methods.
Works closely and cooperatively with Administrative and Clinical staff in identifying and utilizing all alternate resources available to Health Center patients.
Conducts personal in-depth patient interviews to determine eligibility for alternate resources and enrolls patients in third party payor insurance plans.
Registers, enters, and updates patient demographics, health insurance, and employer information data into the EHR patient registration system.
Follows up with patients regarding Medicare, Medicaid, Medi-Cal, and private insurance changes, terminations, and eligibility.
Verifies alternate resource eligibility for Direct Care and Purchased Referred Care.
Stays knowledgeable of alternate resource eligibility requirements and their processing application.
Answers telephone and personal inquiries regarding patient registration and patient benefits coordination and PRC compliance issues.
Follows up with patients and/or tribal offices regarding tribal enrollment and verification.
Provides patient education regarding patient registration, patient benefits coordination, alternate resources program requirements, and Purchased Referred Care compliance.
Performs audit of patient’s files to ensure all needed forms are present.
Performs other duties as required.