Patient Benefits Coordinator I

Gardnerville, United States

Position Title

Patient Benefits Coordinator I

Job Type





NE9 (17.84 - 26.76)


PRC and Wellness


Position Summary

Under direct supervision the Benefits Coordinator I is responsible for providing leadership and advocacy on the behalf of patients by assisting in the obtaining of approval and utilization of benefit programs and alternative resources in coordination with the policies of the Washoe Tribal Health Center. Maintains confidentiality of all privileged information.
Minimum Qualifications
  • High School Diploma or GED and two years experience in a medical office setting; or equivalent combination of education and experience.

  • Must be able to successfully pass a pre-employment drug/alcohol screen and background investigation.

  • Preference will be given to Qualified Native American Indians.

Essential Duties & Responsibilities
  • Determines patient eligibility for Direct Care and/or Contract Health Services.

  • Identifies patients who have or are potentially eligible for alternate resources.

  • Assures maximum identification by implementing effective screenings and interviewing methods.

  • Works closely and cooperatively with Administrative and Clinical staff in identifying and utilizing all alternate resources available to Health Center patients.

  • Conducts personal in-depth patient interviews on a daily basis to determine eligibility for alternate resources.

  • Enters patient demographics, health insurance and employer information data into the RPMS patient registration system.

  • Follows up with patients regarding Medicare, Medicaid, Medi-Cal, and private insurance changes, terminations, and eligibility.

  • Verifies alternate resource eligibility for Direct Care and Contract Health Services.

  • Stays knowledgeable of alternate resource eligibility requirements and their processing application.

  • Collects co-pay and/or deductibles, reconciles collection box daily.

  • Answers telephone and personal inquiries regarding patient registration and patient benefits coordination and CHS compliance issues.

  • Schedules appointments as needed.

  • Submits pre-authorizations for patients.

  • Performs other duties as required.

Knowledge, Abilities, Skills, and Certifications
  • Knowledge of modern office practices, procedures, and equipment.

  • Knowledge of business English, proper spelling, grammar, punctuation, and basic arithmetic.

  • Knowledge of records management and basic accounting procedures.

  • Knowledge of medical/dental terminology preferred.

  • Knowledge of Medicare, Medicaid, Social Security, Federal Health Care legislation including Champus, VA and the Indian Health Care Improvement Act provisions.

  • Ability to communicate effectively in the English language both verbally and in writing.

  • Ability to establish and maintain professional relationships with individuals of varying social and cultural backgrounds and with co-workers at all levels.

  • Ability to represent the organization in a professional manner, building respect and confidence.

  • Ability to maintain confidentiality.

  • Ability to handle multiple tasks and meet deadlines.

  • Ability to carry out instructions furnished in verbal or written format.

  • Ability to work independently with minimal supervision.

  • Ability to demonstrate excellence in everything, and continually seek improvement in results.

  • Skill in operating business computers and office machines, including in a Windows environment, specifically Word, Excel, Access, and presentation software (such as PowerPoint).

Physical Demands
  • While performing the duties of this job, the employee regularly is required to sit; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee frequently is required to walk. The employee occasionally is required to operate a motor vehicle; stand, stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds.

Work Environment
  • Work is generally performed in an office setting with a moderate noise level.