Patient Benefits Coordinator (PBC)

Between $19.67 and $26.67 Per Hour Position range in Albuquerque MSA $18.59

• $29.

08 Per hour Patient Benefits Coordinator (PBC) Haak'u Health Center

Occupation:

Patient Representatives

Location:

Pueblo Of Acoma, NM

• 87034

Job Type:

Full Time (30 Hours or More)

Posted:

07/02/2026 Positions available: 1

Source:

ZipRecruiter

Web Site:

www.ziprecruiter.com

Delivery Method:

ZipRecruiter Job #: 87a07ce6 Job Requirements and Properties Help for Job Requirements and Properties. Opens a new window. Work Onsite Full Time Schedule Full Time Job Description Help for Job Description. Opens a new window. Job DescriptionJob Description The Patient Benefits Coordinator determines eligibility for alternate resources using established criteria, ensuring full entitlement to alternate resources and acts as an advocate for patients to utilize alternate resources effectively. Assures the identification of patients who are eligible for alternate resources and assists parties, with the enrollment process.

ESSENTIAL DUTIES, FUNCTIONS & RESPONSIBILITIES

This list of duties and responsibilities is illustrative only of the tasks performed by this position and is not all inclusive.

• Acts as an advocate for patients in the effective utilization of alternate resources such as Medicare. Medicaid, Department of Veterans Affairs (DVA), Third Party Payers, Children's Rehabilitative Services, Temporary Assistance for Needy families (TANF), New Mexico Kids Care programs, Worker's Compensation, etc.
• Educates Patient Registration staff, other Health Center staff, and patients on alternate resources that are available.
• Interprets regulations, policies and procedures established by alternate resource agencies such as those listed above.
• Provides a full range of services related to PRC (Purchase Referred Care), business office, medical records and clinic administration.
• Determines alternate resources available to patients and verifies eligibility contacting the nearest Social Security Administration (SSA).

State Medical Assistance Office and private insurance entities to verify the eligibility of patients. Establishes eligibility of potential Medicare eligible clients by working with the Social Security Administration (SSA). Acts as an advocate for patient in the effective utilization of alternate resources such as Medicare, Medicaid, Department of Veterans Affairs (DVA), Third Party Payers, Children's Rehabilitative Services, Temporary Assistance for Needy Families (TANF), Kew Mexico Kids Care programs, Worker's Compensation, etc.

• Educates Patient Registration staff. Other Health Center staff, and patients on alternate resources that are available.
• Interprets regulations, policies and procedures established by alternate resource agencies such as those listed above.
• Provides a full range of services related to PRC (Purchase Referred Care), business office, medical records and clinic administration.
• Determines alternate resources available to patients and verifies eligibility by contacting the nearest Social Security Administration (SSA).

State Medical Assistance Office and private insurance entities to verify the eligibility of patients. Establishes eligibility of potential Medicare eligible clients by working with the Social Security Administration (SSA) on both the local and regional levels. Works closely with local County Department of Medical Assistance and Tribal Offices to establish eligibility for Medicaid, TANF, Supplemental Social Security Income (SSI), etc.

• Interviews with all patients eligible for Medicare and Medicaid benefits to ensure they understand their benefits.
• Assists families and individuals in applying for and utilizing alternate resources.
• Works closely with various disciplines such as Discharge Planning, Utilization Review, Social Services, etc., to coordinate medical care services; obtains required authorizations or concurrent reviews and bases the ability to understand and explain billing methodology and collections for HHC.
• Ensures timely submission and accuracy of alternate resource applications and that follow-up is conducted, within the established timeframes to meet eligibility requirements. Work closely with families and agencies to ensure that patients are not discriminated against.
• Provides information on rights and benefits of resources and tactfully advises patients of non-payment or denial of claim.
• Disseminate information through proper channels in accordance with established procedures and perform other general clerical tasks necessary in carrying out patient appointment functions.
• Obtains from the patient, proof of tribal enrollment for medical eligibility.
• Maintains sufficient health records forms, authorizations or clinic information, eligibility forms and standard forms explaining the patient's rights under the Privacy Act and HIPAA.
• Maintains a current checking system on each patient receiving medical care from the Health Center. This consists of contacting various Federal, State and County agencies to verify current eligibility for third party health insurance and their identifying numbers.
• Prepares and compiles the authorization for release of medical information, assignment of benefits and pre-certification. Gathers and compiles information needed to determine benefits or benefits related healthcare services for all third party billin2 purposes and processes.
• Performs daily interviews to obtain specific demographic and insurance information in a diplomatic and confidential manner.
• Plans and carries out the work of the office and handles problems and deviations in accordance with established instructions and priorities. policies, commitments and program goals of the supervisor and accepted practices in the occupation.
• Provide technical PRC information and guidance on all inquiries. Ensure prompt follow up with appropriate personnel and vendors maintaining strict confidentiality.
• All staff will be cross trained to aid in Patient Registration, Patient Benefits Coordination, and Medical Records. Knowledge of various types of health policies and types of coverage, terminal digit filing systems, answering phones preferred but not required. Prepares routine correspondence when appropriate to patients, and providers.
• Performs all other duties as assigned.

MINIMUM MANDATORY QUALIFICATIONS

Experience:

o At least one (1) year experience in providing eligibility services. This experience would need to include skills such as, interviewing patients, determining eligibility for various types of resource benefits, Third Party billing, Medicare, Medicaid, etc., verifying insurance information and utilizing NextGen.

Education:

o High School Diploma or GED equivalent, or an equivalent combination of education and/or experience may be considered.

• Must pass all background checks.

PREFERRED QUALIFICATIONS

• Bilingual skills in English and the Keres native language.
• Prior experience working with Indian Health Services (IHS), a Tribe or Tribal Organization.

Company DescriptionHaak'u Health Center, formally Acoma/Canoncito/Laguna (ACL) Clinic is now hiring! Please consider joining the Haak'u Health Center team.

Company DescriptionHaak'u Health Center, formally Acoma/Canoncito/Laguna (ACL) Clinic is now hiring! Please consider joining the Haak'u Health Center team.