This position will be under the direct supervision of the CHS Supervisor. This individual will be responsible for determining, assisting patients in applying and following through with alternate resource referrals as well as assisting in all aspect of Contract Health Services as necessary.
MAJOR TASKS AND RESPONSIBILITIES:
Job Skills and Duties.
- To be in attendance and on time.
- Identify patients who may be eligible for alternate resources.
- Refer patients that may be eligible for alternate resources such as but not limited to state, federal, disability or commercial insurance companies.
- Initiate patient referrals.
- Send notices and reminders to patient regarding applying for alternate resources.
- Assist patients with applications and correspondence.
- Monitor and track application status and compliance.
- Monitor and track spend downs.
- Submit spend downs to DSHS upon receipt.
- Request claims immediately after services has been rendered so that charges can be applied to spend downs.
- Monitor and track award notices or denials.
- Monitor and track when a patient is due to reapply.
- Identify when patients are eligible for Medicare Programs and assist them with their application.
- Coordinate Medicare Reimbursements, COBRA and other supplemental coverage in conjunction with established policies and procedures.
- Update the RPMS insurance page as necessary.
- Notify necessary staff when a patient is referred for alternate resources and the status of the referral.
- Work with other departments and social worker on patient referrals for alternate resource.
- Compile and be familiar with state and federal department contacts.
- Attend trainings that are necessary to perform duties or as directed.
- Adheres to safety policies and procedures within the health program.
- Reports inappropriate incidents by filing incident reports and forwarding the report to the Practice Manager.
- Respond to emergencies in a calm and professional manner and report to designated area and or person in case of an emergency.
- Represents Muckleshoot Indian Tribe (MIT) Health Program in a positive and professional manner when interacting with patients and the community.
- Demonstrate positive interpersonal relations skills in dealing with staff, providers and management.
- Consistently maintains confidentiality and follows HIPAA guidelines in regards to patient information as well as Health Program operations.
- Participates in staff meetings .
Because of the Tribe’s commitment to community service and the well being of the members, each employee may be expected to perform a wide range of office and field duties from time to time. Such duties may or may not be related to their regular duties.
EDUCATION - EXPERIENCE AND TRAINING FOR POSITION:
Graduation from a high school or equivalent with course work in general office practices, two (2) years of experience in an office, administrative, or related support position is required, two (2) years experience and knowledge of commercial, state and federal insurance companies or the ability, competentcy and willingness to become knowledgeable of such and to demonstrate learned knowledge within a specific time set by the Tribe. Some assignments may require program specific certifications at a time set by the Tribe.
SPECIFIC SKILLS/KNOWLEDGE/ABILITIES REQUIRED FOR POSITION:
Knowledge: general office principles and practices, operation of standard office equipment that may include typewriter, personal computer, copier, fax machines and multi-line telephone, software applications relative to the position assignment, basic mathematics. Skills: keyboarding (speed required may vary according to position assignment), word processing (knowledge of software programs varies according to position assignment), oral and written communications, interpersonal and human relations, problem-solving, customer service ¾ in person and via telephone (discretion, patience, etiquette, professionalism) following oral and written instructions, prioritizing workload and adapting to changes in work load demand, providing limited training, maintaining confidentiality of sensitive matters, following through on assignments as directed, initiative and accountability skills for work product or service.
Licenses or Certifications Required: