Patient Benefits Coordinator
Company: K'ima:w Medical Center
Posted on: September 19, 2018
Job DescriptionDepartment: BenefitsReports To: Director of NursesFLSA Status: Non-ExemptWe are seeking a Patient Benefits Coordinator - ICW to join our team!You will: identify patients with eligibility for alternate resources, assisting them with the enrollment process, acts as advocates for Indian patients in the effective utilization of alternate resources, assists clients with other social service needs and updates all established patients and inputs all new patient registrations into RPMS. FUNCTIONS & RESPONSIBILITIESGreets and interviews clients to obtain and record all required information in the facility computer data base.Works closely with facility staff to identify all alternate resources available. Assist clients in application for use of alternate resources. Assist patients in establishing and verifying eligibility for alternate resources and must work closely with the local and regional Social Security Administration office, Tribal Offices, Department of Social Services, State Medical Assistance Office, and other appropriate agencies. Independently determines patient eligibility for Medicare, California State Medicaid, Department of Veterans Affairs, Third Party Liability, Workmen’s Compensation, Private Insurance, state programs, Covered California, BCEDP, Presumptive eligibility and any other applicable resources. Contacts alternate agencies through telephone, correspondence and personal visits to ensure maximum utilization. Conducts personal interviews with client and/or family member to determine potential eligibility for any alternate resources and assists with the application and follow through until completion. Follows up on all pending applications and works closely with families and agencies so that the patients are not discriminated against. Performs a variety of patient representative functions including completions of application for alternate resources,Supervises Front Desk Medical Receptionist, trains, etc. Social security, in-home support services, etc. Insure input of monthly calendar in BMW Scheduling module. Other duties as assigned. SUPERVISORY RESPONSIBILITIES:Directly supervises 2 employees in the PRC Indian Health Service Regulations Department and carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, recommendations to hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints, resolving problems as well as develops job descriptions and performance criteria for staff. Must submit written monthly reports to be submitted no later than 14 days after the end of the month, to be submitted to the Executive Secretary. Must submit written budget and capital budget for each fiscal year by the announced due date must submit these including narratives for each line item to the Controller. Must complete employee evaluations and job descriptions updates by January 30 of each year. This to include competency requirements and training plans and submit to the Executive Secretary. Must provide Department Specific Orientation to all new staff during the first day of work, orientation must address all aspects of Environment of Care. A signature sheet for documentation shall be completed. Must be responsible to make certain all staff are in compliance with CPR requirement, TB testing and immunization and any required certification. Must provide monthly staff meetings for Department specific staff and appropriate minutes of meetings must be kept. Must participate in appropriate committees; Performance Improvement, Managers Meetings, and Staff Meetings. At the end of each calendar year must submit an annual report to the Executive Secretary no later than January 30. Must provide self audits of Department work, with documentation of deficiencies and corrections. Must provide customer satisfaction surveys if applicable. QUALIFICATIONS:To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable with disabilities to perform the essential functions. BASIC REQUIRED ABILITYJOINT COMMISSION RESPONSIBILITIES: Responsible for helping to prepare, achieve, and maintain accreditation by the Joint Commission on Accreditation of Healthcare Organizations. By serving on the various performance improvement subcommittees individual employees are directly involved in the generation or modification of policies & procedures that enable KMC to provide continuously improving healthcare. PUBLIC RELATIONS/ADVANCED INTERPERSONAL SKILLS: Addresses clients by name; smiles when talking to clients, physicians. Peers, and families; answers the telephone courteously and promptly; identifies self and department when answering the telephone using pleasant voice tone/verbiage; possesses excellent listening skills; interacts with clients and peers. COOPERATION: Must be a self-starter; seeks solutions; accepts constructive criticism; willing to adjust to changes; loyal to K’ima:w Medical Center. PROFESSIONALISM: Shows pride in personal appearance and grooming; displays a positive attitude about work; respects the confidentiality of clients; and is congenial with public and peers. INITIATIVE: Willing to participate in continuing education programs; asks questions; contributes during staff meetings; serves on K’ima:w Medical Center committees as appointed, demonstrates a desire for self improvement. JOB SPECIFIC SKILLS & ABILITIESDemonstrated ability to perform processes in the delivery of care to specific age groups.Demonstrated skill in operation of computer, calculator, and other office equipment.Demonstrated ability to work independently, establish priorities and meet deadlines.Demonstrated knowledge of maintaining and managing files and records.Type a minimum of 45 wpm.Experience with the Affordable Care Act, California State Medicaid, Medicare and SSI (Regulations, Guidelines, Policies & Procedures). EDUCATION and/or EXPERIENCEHigh School Diploma or equivalent G.E.D.6 months related experience and/or training or equivalent combination of education and experience. CERTIFICATES, LICENSES, REGISTRATIONSCurrent CPR CertificateValid California Drivers License LANGUAGE SKILLSAbility to read an comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization. Demonstrated knowledge of grammar, spelling, punctuation and common technology. REASONING ABILITYAbility to add and subtract two digit numbers and to multiply and divide with 10's and 100's. Ability to perform these operations using units of American money and weight measurement, volume, and distance. CONFIDENTIALITYEmployee must be aware of and adhere to K’ima:w Medical Center’s Confidentiality Policy and deal appropriately with patient confidentiality at all times. CONDITIONS OF EMPLOYMENTEmployee is subject to baseline and random drug testing per the Hoopa Tribal Drug & Alcohol Fit for Duty Policy. Employee will serve a 90-day introductory period. Employee is subject to introductory and semiannual performance evaluations. Preference will be given to qualified Indian applicants pursuant to the Tribe’s TERO Ordinance. PHYSICAL DEMANDSThe physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. WORK ENVIRONMENT:The work environment characteristics described here are representative of those and employee encounters while performing the essential functions of this job. Reasonable accommodations may be make to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is occasionally exposed to blood borne pathogens, airborne formites, infections, and other contagious diseases and outside weather conditions. The noise level in the work environment is usually moderate. ANNUAL TRAINING REQUIREMENTS At a minimum Employee is required to be certified for the following training:KMC Annual Orientation, to include infection control, safety, & personnel policies, etc.CPR every two years.Company DescriptionWe are located in a small valley in the Trinity Alps of Northern California.We are part of the Hoopa Valley tribe. K'ima:w means "Good Medicine" in the local Hoopa language. Our community has been fortunate to still practice and have knowledge of our ancient culture. Most of our staff are locals and we are more than happy to welcome motivated, skilled, and happy individuals.This is a great place to obtain experience for your career.Get help with your student loans through Indian Health Services' Loan Repayment Program for qualified positions.
Keywords: K'ima:w Medical Center, Redding , Patient Benefits Coordinator, Other , Redding, California
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