Health Systems Specialist (X2) Job at Confederated Tribes of Warm Springs, Warm Springs, OR

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  • Confederated Tribes of Warm Springs
  • Warm Springs, OR

Job Description

Job Description

Job Description

Process Indian Health Service patient referral to outside providers, verify & ensure all referrals are through IHS physicians & referred patients are MCP eligible. Provide assistance to outside provider offices regarding MCP referrals, claims and payments. Educate MCP patient of the referral process, applying for alternate resources, answering all patient & provider questions in a considerate & timely manner. Research & process medical claims weekly for prompt payment, resolve incomplete claims, process claims for denial. Receive and research patient billing statements, by calling providers and ensuring patient insurances are billed, and request all required documents to be submitted to MCP.

Requirements

High School diploma or equivalent required. Maintain Strict Patient & Medical Records confidentiality! Knowledge of Medicare, Medicaid; also familiar of the Tribes Benefit Plan, Healthcare Management Administrators (HMA). Familiar with The Warm Springs Community is essential. Able to utilize electronic documents filing & scanning system in daily processes. Have knowledge of CPT & ICD 10; familiar with medical terminology. Maintain positive professional work relationships with supervisors, coworkers, patients & providers. Positive attitude & high motivation are prime importance, must have a high work ethic with the ability to work under minimal supervision, and able to accomplish other duties as assigned. Must submit and pass a criminal background check with Federal, Tribal and State Law Enforcement and submit and pass a pre-employment alcohol and drug screening.

Benefits

Benefits include: Excellent medical insurance with low annual maximum-out-of-pocket costs, plus vision and dental. Available flex spending plan for daycare and medical costs. Also available are numerous supplemental insurance packages. 401(k) or ROTH retirement with up to 5% employer matching after one year of employment. Eleven days of paid holidays and Personal time off (PTO) accruing at 130 hours annually with increases after three years of service.

Job Tags

Weekly pay,

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