Health Services Coordinator

Health Services Coordinator King William, VA 23086 Up to $68,000 a year - Full-time Up to $68,000 a year - Full-time Job Summary Pamunkey Indian Tribe's (PIT) Health Services Department strives to maximize the physical, emotional, spiritual, and social wellbeing of Pamunkey citizens by providing quality medical and support services. The department operates a financial reimbursement program that pays for citizens' dental and medical services, including urgent/ER and specialty care, and is developing plans to offer onsite physical therapy. The Health Services Department also collaborates closely with Enrollment & Citizen Services to administer grants and develop health-related programming. Under the supervision of the Health Services Director, the Health Services Coordinator will provide support to the various staff and programs under the department's purview. The successful applicant will screen applications for program eligibility, ensure the proper completion and storage of documentation, maintain and update programmatic data, develop health communications and educational materials, deliver presentations, provide internal/external customer service, process financial payments, and perform general administrative support for a variety of health-related programs. Responsibilities Patient Screening Conduct screenings and assist with applications to any applicable health insurance programs for which the patient may be eligible (Medicaid, Medicare, Federal Marketplace, etc.). Verify program eligibility and notify patients of determination. Assist patients with all components of program compliance, to include meeting eligibility, residency, and alternate resource requirements. Register eligible patients and maintain updated enrollment spreadsheets. Fiscal Administration, Medical Coding, & Billing Ensure payment for healthcare services is submitted timely and in compliance with the Health Insurance Portability and Accountability Act as well as Pamunkey Indian Tribe policies and procedures. Utilize Microix software to execute purchase orders and track financial payments. Submit, monitor, and pursue unpaid medical claims. Customer Service Educate individuals on PIT medical and support services available. Empathetically listen to patient billing issues and advocate for their resolution. Maintain awareness of programmatic concerns and make process improvement recommendations. Respond to inquiries and requests for assistance. Administrative Coordination Issue correspondence related to program authorizations/denials for payment. Prepare and maintain patient files, including updates, consents, and other important information. Maintain accurate records and reports on program enrollment and service utilization. Obtain patient signatures and enter patient data in various software programs. Collect documentation from providers, patients, and insurance entities. Verify patient data, including primary insurance status/benefits and availability of alternate resources. Collect and analyze data, write reports, and prepare presentations. Perform other duties as assigned. Patient Screening Conduct screenings and assist with applications to any applicable health insurance programs for which the patient may be eligible (Medicaid, Medicare, Federal Marketplace, etc.). Verify program eligibility and notify patients of determination. Assist patients with all components of program compliance, to include meeting eligibility, residency, and alternate resource requirements. Register eligible patients and maintain updated enrollment spreadsheets. Fiscal Administration, Medical Coding, & Billing Ensure payment for healthcare services is submitted timely and in compliance with the Health Insurance Portability and Accountability Act as well as Pamunkey Indian Tribe policies and procedures. Utilize Microix software to execute purchase orders and track financial payments. Submit, monitor, and pursue unpaid medical claims. Customer Service Educate individuals on PIT medical and support services available. Empathetically listen to patient billing issues and advocate for their resolution. Maintain awareness of programmatic concerns and make process improvement recommendations. Respond to inquiries and requests for assistance. Administrative Coordination Issue correspondence related to program authorizations/denials for payment. Prepare and maintain patient files, including updates, consents, and other important information. Maintain accurate records and reports on program enrollment and service utilization. Obtain patient signatures and enter patient data in various software programs. Collect documentation from providers, patients, and insurance entities. Verify patient data, including primary insurance status/benefits and availability of alternate resources. Collect and analyze data, write reports, and prepare presentations. Perform other duties as assigned.

Required Qualifications Either:

Bachelor's degree in public health, public/healthcare administration, health sciences, or related field or Bachelor's degree with at least two years of related experience. Familiarity with healthcare billing practices and terminology, including the health insurance industry, billing/claims, explanations of benefits, and referrals. Ability to perform various functions/formulas in Microsoft Excel and excellent command of Word. Superb organizational and data management skills. Ability to independently anticipate and solve problems. Ability to provide excellent customer service and establish professional relationships. Ability to maintain strict confidentiality and adhere to all HIPAA guidelines/regulations. Ability to communicate clearly and professionally with various stakeholders, both orally and in writing. Ability to create health education materials and deliver presentations. Ability to understand and implement frequent changes to program guidelines and processes. Ability to work in an office setting with public interaction and frequent interruptions. Preferred Qualifications 3+ years' experience in health-related program administration. Completion of programs/training in medical office terminology and billing. Experience with Indian Health Service and/or Purchased/Referred Care programs. Native Preference In accordance with Indian Self Determination and Education Act (25 USC, Section 450(c)), it is the Pamunkey Tribe's policy to give preferential treatment to qualified members of federally recognized tribes in hiring and promotions. The following order of preference shall apply: 1. Enrolled member of the Pamunkey Indian Tribe. 2. Enrolled member of a federally recognized tribe. 3. Others. Applicants claiming Indian preference must submit supporting documentation, such as: 1. Verification from an authorized representative of membership in an Indian tribe, band, or other organized group. 2. A tribal membership or voter registration card. Accommodations The position requires the ability to perform the noted essential job duties as outlined above. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Pay:

Up to $68,000.00 per year

Benefits:

Dental insurance Health insurance Paid time off Professional development assistance Vision insurance

Work Location:

In person