PRC Benefits Coordinator

General Information

Job Title: PRC Benefits Coordinator

Contact: Human Resources, (907)228-9316

Date Posted: 10/01/2024

Location: Purchased & Referred Care

Compensation and Hours

Minimum Salary: $21.85/Hour

Maximum Salary: $32.78/Hour

Type of Job: Full Time

Hours per Week: 40

Benefits: Health/Dental/Vision/401K

Anticipated Job Duration: None Selected

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Job Description

Indian Preference in hiring is given to qualified enrolled members of Ketchikan Indian Community (KIC) and Native Americans consistent with P.L. 93-638 and in accordance with KIC policy and other applicable federal laws.

Purpose

Ketchikan Indian Community (KIC) job descriptions are a management tool to help organize duties and provide employees with the employer’s expectations with regard to a specific job classification. The responsibilities listed are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is a reasonable assignment for the position. This job description is not an employment agreement or contract. Management has the exclusive right to alter this job description at any time without notice.

Job Summary

Incumbent is responsible for collecting private insurance coverage information to maximize the clinic’s use of alternate resources.

Job Duties & Responsibilities

· Establish procedures to identify alternate resources such as Medicare, Medicaid, Private Insurance, Veterans’ administration, Tribal Sponsored Health Plans (TSHIP), etc. enrollment.

· Prepares necessary reports providing statistical analysis and assist in monthly TSHIP and governance reporting requirements.

· Collects appropriate data, insurance information on all patients from various sources.

· Interviews patients (and/or family), other providers, and insurance companies.

· Sends insurance questionnaires, reviews administrative files, and screens for third party coverage.

· Interviews and enrolls veterans for the Veterans Administration Department benefits.

· Assists those who may be eligible for Medicaid/Medicare by arranging patient contact with correct agency.

· Serves as liaison between KIC Clinic, patients, and other health care providers in the collection of alternate resource information.

· Develops and maintains cooperative relationships between Indian Health Service, Tribally-managed facilities and other agencies to assist in the exchange of information.

· Cross-trains co-workers in the department to the related functions of this position in order to provide back-up coverage in his/her absence.

· Receives cross training in other department positions, related duties, providing backup as necessary.

· Other duties as assigned

Minimum Qualifications (Education & Experience)

· Highschool Diploma or Equivalent.

· One (1) year medical field knowledge or progressive responsible clerical, office or other work that indicates ability to acquire the particular knowledge and skills needed to perform duties of this position.

· A combination of relevant experience, education, and training may substitute for education and experience requirements on a year-for-year basis.

· Proof of valid driver's license with acceptable driving record (when DL is required for the job).

Preferred Qualifications (Education & Experience)

· Additional training courses in clerical field.

· Experience in community clinic preferred and a strong commitment to multi-disciplinary teamwork.

Necessary Knowledge, Skills, and Abilities

· Strong understanding and sensitivity to American Indian/Alaska Native (AI/AN) Tribal culture and lifestyle, working effectively with AI/AN populations.

· Effective oral and written communication skills with sensitivity to the lifestyles of targeted participants.

· Skills in operating personal computers using a variety of computer software.

· Ability to establish and maintain cooperative working relationships with management, coworkers, and outside contacts.

· Ability to maintain strict confidentiality and comply with all applicable federal and tribal privacy laws and KIC policy (HIPAA, HITECH, etc.).

· Ability to learn and apply program/agency operating policies and procedures.

· Ability to manage multiple priorities and tasks concurrently and meet deadlines.

· Ability to work independently as well as with teams.

KIC Competencies

Cultural Competency: To be respectful and responsive to the health beliefs, practices, and cultural and linguistic needs of KIC Tribal Members. Developing cultural competence is an evolving, dynamic process that takes time and occurs along a continuum .

Commitment: To serve Tribal Members and set a high standard for yourself in your performance; strive for results and success; convey a sense of urgency and bring issues to closure; and stay persistent despite obstacles and opposition.

Customer Service: Meet/exceed the expectations and requirements of internal and external customers; identify, understand, and monitor the needs of both internal and external customers; always talk and act with customers in mind; and recognize working colleagues as customers.

Effective Communication: Ensure important information is passed to those who need to know; convey necessary information with respect, clearly and effectively orally or in writing

Responsiveness and Accountability : Demonstrate a high level of conscientiousness; hold oneself personally responsible for one's own work; and do the required fair share of work.

Working Conditions

The physical demands described here are representative of those that an employee must meet to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform these functions.

While performing the duties of this Job, the employee is regularly required to use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee is frequently required to stand and/or sit. The employee is occasionally required to walk, sit, climb, or balance. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, peripheral vision, and depth perception. The noise level in the work environment is usually average.

The environment involves the usual risks and stress of an ambulatory healthcare facility. The employee may be exposed to communicable diseases. Safety precautions for employees such as blood drawing for screening of various diseases such as hepatitis, tuberculosis, required immunizations, etc. are necessary. The employee is occasionally subject to verbal abuse, threats, and physical violence from angry, hostile, or disgruntled patients and/or family members.

Conditions of Hire

May be required to possess and maintain a valid driver's license or capable of obtaining one, as well as be insurable by KIC’s company insurance.

KIC is a Drug-Free Workplace. All employees must adhere to KIC drug and alcohol policies and procedures to ensure a safe workplace. Employees must pass a pre-employment and subsequent random and/or for cause drug and alcohol screening to be eligible for and maintain employment.

KIC has several positions that must comply with the P.L. 101-630 Indian Child Protection and Family Violence Protection Act (ICPA); all employment offers in the " covered" classification are conditional until KIC has received a Federal criminal background check verifying eligibility to work in these programs.

Required Job Qualifications

Can you pass a drug test?

Are you 18 or older?

02.(a). Education - Do you have a GED or High School diploma

Do you have a pending charge or past conviction for DWI/DUI?

Do you have any pending charge(s) or past conviction(s) for possession of a controlled substance?

Has your driver's license, permit, or privilege ever been suspended or revoked?

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