Job Description

Job Summary:

Provides administrative support under general supervision for the Tribal members, spouses and dependents benefit's plans along with the Indian Health Services (IHS) program and Contract Health Services for Native Americans living in Scott county.

Job Duties:

Performs one or more of the following:

1. Enrollment of Tribal members, spouses and dependents into the SMSC benefit programs via electronic portal.
2. Process medical and dental insurance claims.
3. Maintain patient records in various health care settings.
4. Internal communication with other staff members from various on-site clinics.
5. Communication and coordinator of benefits with off-site care providers and insurance providers.
6. Update electronic patient management system.
7. Store and organize patients' file, billing details, and registration/enrollment forms.
8. Resolve any issues with coverage and escalate complicated issues to supervisor. Maintain quality customer service by following customer service practices; responding to customer inquiries.
9. Protect operations by keeping claim information confidential.
10. Serves as the primary contact person for all prospective IHS recipients and completes the intake interview.
11. Makes the preliminary determination concerning each applicant's eligibility for services and confers with the Health Administrator on eligibility questions as needed.
12. Establishes and maintains records for IHS applicants and recipients and also maintains up to date enrollment records. Enters related data into RPMS.
13. Communicates with IHS representatives, SMSC Health clinics staff, non-IHS providers, as well as representatives from public and private health insurance agencies as needed to coordinate payment for services.

Ensures legal compliance by following company policies, procedures, guidelines, as well as applicable state or federal insurance regulations.

Prepares reports by collecting, analyzing and summarizing information.

Days Monday - Friday Hiring Rate or Hiring Range Based on qualifications Requirements

1. Two years post-secondary education in Business, Administration or related field.
2. Two years experience processing contract health benefits or Tribal public policy administration.
3. Knowledge of electronic health records and third party billing systems.
4. Experience working with Medicare or federal grant program management.
5. Experience with accounting principles/posting insurance payments or federal grant program management.
6. Strong computer skills to include but not limited to Microsoft Office Word, Excel, Outlook, and PowerPoint.
7. Good verbal and written communication skills.
8. Must hold and maintain Cardio Pulmonary Resuscitation (CPR) certification. If not CPR certified upon hire, must obtain certification within 90 days of employment.