Snoqualmie Tribe
  • 11-Oct-2017 to 25-Oct-2017 (PST)
  • Health and Wellness
  • Snoqualmie, WA, USA
  • 20.06
  • Hourly
  • Full-time

Competitive medical, dental, life and disability insurance benefits after 60 days employment; 401k retirement plan after 90 days employment; generous paid holidays, vacation, and sick leave.


POSITION SUMMARY

The Contract Health Services Coordinator ensures all eligible Snoqualmie Indian Tribal members have access to medical, dental, and vision health care as provided by Indian Health Service and the Snoqualmie Indian Tribe. Assist Tribal members to complete necessary applications, help obtain alternative resources, provide referrals, and collect required documents for payment.

This position ensures all IHS requirements are met for eligible clients and assist in all daily operations of the CHS program. Administer contracted health care to eligible clients according to federal rules and regulations and based on annual fixed funding base. Assume dual responsibility for processing routine and complex health claims and for providing customer service for assigned accounts. Assume primary responsibility for processing routine complex health claims on multiple assigned accounts. Act as a resource for clients, community members, and other Health and Wellness department staff.

This is an hourly, non-exempt position that reports to the CHS Manager.

ESSENTIAL FUNCTIONS

  • Build, establish and maintain excellent working relationships with all internal and external sources.
  • Ensure all IHS eligibility criteria requirements are met before clients receive services.
  • Ensure all other alternate services have been exhausted for clients, maintain current knowledge of all other alternative resources, and give accurate information on how the client may obtain available resources.
  • Follow rules, guidelines, and procedures to solve problems. Work as a team member and handle difficult situations in a calm and professional manner.
  • Determine level of medical services required within IHS/Tribal priorities. Inform clients of services not covered in a professional manner.
  • Assist other CHS staff with claims as needed to minimize backlog.
  • Perform routine and complex administrative and clerical tasks accurately under time constraints and high pressure environment to maintain current procedures, medical claim processing resources, and updated CHS RPMS claim systems data.
  • Conduct in-depth research to resolve medical claims issues and compose detailed and customized communications as needed.
  • Assist patients and other Health and Wellness staff with questions on processing medical claims, direct questions and issues to appropriate persons as needed.
  • Independently process routine medical and complex health claims of all types in line with all private, state, and federal plans with primary client service responsibility.
  • Communicate with tact and discretion while maintaining a high level of confidentiality in line with HIPAA and related regulations and policies.
  • General administrative office and other duties as assigned.

QUALIFICATIONS

  • High school diploma or equivalent required. Higher education degree preferred.
  • Two or more years' related work experience required. Experience with IHS tribal health programs preferred.
  • Experience with private insurance, Medicaid, and Medicare programs preferred.
  • HIPAA certification required within 45 days of employment. Must maintain HIPAA certification throughout duration of employment.
  • Ability to maintain high level of confidentiality and use tact and discretion.
  • Successfully complete Tribal Assister Training within 90 days of employment.
  • Proficiency with Microsoft Office Programs required. 10-key and 35 WPM required.
  • Strong organizational skills, accuracy, and attention to detail.
  • Excellent written and verbal communication skills. Demonstrated ability to communicate effectively with diverse populations.
  • Must be able to pass pre-employment and random drug screenings.
  • Must pass background check.

Additional Information

  • Pay starts at $20.06 per hour.
  • Competitive medical, dental, life and disability insurance benefits after 60 days employment.
  • 401k retirement plan with employer matching contributions after 90 days employment.
  • Generous paid holidays, vacation, and sick leave.
  • The 8 hour work shift includes a paid lunch hour.
  • This is a full-time, hourly non-exempt position and employment is at-will.

The Snoqualmie Tribe gives Indian preference to candidates who can provide proof of enrollment in a federally recognized tribe. In the absence of qualified Indian applicants who meet the qualifications listed above, all applicants not entitled to or who do not claim Indian preference, will receive consideration without regard to race, color, religion, sex, national origin, age, disability, or any other characteristic protected by law.

Snoqualmie Tribe
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