Patient Resource/Benefits Coordinator

Oklahoma City Indian Clinic•Oklahoma City, OK

3d•Onsite

About The Position

Oklahoma City Indian Clinic (OKCIC) is a non-profit corporation that provides culturally sensitive health care to the American Indian population. OKCIC services include not only basic medical care but also dental, optometry, behavioral health, fitness, nutrition, and other family programs. Our mission is to provide excellent healthcare to American Indians. We do this by putting people first, providing quality services, and maintaining our Integrity and Professionalism. We are looking to add compassionate team players to our growing team as we continue to work toward our goal of becoming the national model for American Indian Health Care. OKCIC is seeking a Benefit Coordinator to join our team. This position will screen patients for Medicare, Medicaid, Affordable Care Act, and Marketplace services for which they may be eligible. Candidates must have excellent people skills, enjoy helping the community, and have strong computer skills. The position does require ongoing research of specific benefit changes. Applicants claiming Indian Preference must complete the full application and must provide documentation verifying eligibility (such as a tribal enrollment card or Certificate of Degree of Indian Blood (CDIB)).

Requirements

High school diploma or GED
Two (2) years of progressively responsible, related experience, sufficient to perform the major duties of the position.
Experience in a healthcare business office, medical insurance office, eligibility determination, or other medical office-related experience
Strong computer skills
Knowledge of healthcare third-party payers and healthcare reimbursement
Must have excellent customer service and interpersonal skills
Ability to speak effectively and respond to questions.
Knowledge, intellect, temperament, and flexibility to work effectively in a fast-paced environment while maintaining excellent customer service.

Nice To Haves

Certified Medicare Assistance Counselor through the Oklahoma Insurance Department or ability to obtain certification within first year of employment.

Responsibilities

Conducts personal interviews with new and established patients to determine eligibility for alternate healthcare resources and ensures patients understand their benefits, eligibility, and responsibilities.
Explains the Indian Health Care Improvement Act Amendments of 1988 and the requirement to seek payment from available medical programs for which the patient may be eligible.
Communicates with patients and families in a respectful, professional, culturally responsive, and CMS-compliant manner.
Uses plain language to explain complex benefit programs and confirms patient understanding.
Identifies barriers such as health literacy, language, disability, technology access, or other needs and coordinates appropriate interpreter or communication services when necessary.
Maintains professional boundaries while advocating for patients.
Verifies Medicaid eligibility through the Oklahoma Health Care Authority (OHCA) eligibility verification system on the date of service and updates Medicaid status in the RPMS system, including termination dates.
Verifies private insurance and Medicare eligibility through designated online resources to determine active or terminated coverage.
Determines eligibility for Oklahoma Medicaid programs, including SoonerCare, SoonerPlan, and Insure Oklahoma; submits applications through the SoonerCare Agency View portal, follows up on pending applications, and updates Medicaid information in RPMS upon approval.
Obtains reports to monitor SoonerCare termination dates and assists patients with Medicaid renewals and recertifications.
Provides education, outreach, and enrollment assistance regarding the Health Insurance Marketplace and Affordable Care Act (ACA), including determining eligibility for premium tax credits and plan coverage options.
Conducts plan comparisons for patients during Marketplace open enrollment and assists patients in evaluating available coverage options.
Scans and indexes administrative documents into the patient record using the VistA Image Capture client in accordance with quality assurance standards. Documents may include registration forms, insurance cards, Medicare cards, driver's licenses, CDIB cards, tribal membership cards, eligibility documents, birth certificates, death certificates, and pertinent legal documents.
Verifies private insurance eligibility using designated online resources.
Collaborates with Patient Resource Services, Purchased/Referred Care, OKCIC Ancillary Services, Pharmacy, Billing, Health Information Management, Case Management, clinical departments, and other appropriate areas to coordinate patient benefits and services.
Communicates changes in patient coverage to appropriate revenue-cycle departments.
Provides back-up support to Patient Resource Representatives and registration staff as needed.
Participates in departmental meetings, required training, continuing education, community outreach activities, and quality improvement initiatives.
Employee may be required to work at multiple organizational locations or participate in outreach activities based on operational needs.