Health System Specialist

Process IHS 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 & payments. Educate MCP patients 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 & research patient billing statements, by calling providers and ensuring patient insurances are billed, and request all required documents to be submitted to MCP. Maintain Patient & Medical Records confidentiality. Knowledge of Medicare, Medicaid; also familiar of the Tribes Benefit Plan, Health Comp. Familiar with The Warm Spring Community is essential. Able to utilize electronic documents filing & scanning system in daily processes, Have knowledge of CPT & ICD 10;

familiar w/Medical terminology. Maintain positive professional work relationships w/ Supervisor, coworkers, patients & providers. Positive attitude & high motivation are prime importance, must have a high work ethic w/ability to work under minimal supervision, and able to accomplish other duties as assigned.

• High School Diploma or equivalent, w/ (3) years medial office experience.
• Medical Terminology, claims processing & highly experienced w/computers & telephone use.
• Proficient written & oral communication skills required.
• Requires reliable attendance & constructive workplace behavior.
• Must submit and pass a criminal background check with Federal, Tribal and State Law Enforcement.

• 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) and 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 continuous service.