Member Services Representative - level I

SUMMARY:

This position shall be responsible for the registration process and for assisting United Indian Health Services (UIHS) clients with eligibility and application into various health benefit programs. This position will also be responsible for initiating, tracking, processing and reporting the status of all benefit applications. 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Reports to the Member Services Specialist or Member Services Manager for daily oversight and general processes.
• Greet all clients and visitors in a warm friendly manner.
• Demonstrate excellent customer service skills.
• Ability to handle difficult or confrontational situations in a calm, consistent, and equitable manner.
• Register new clients verifying the client meets all eligibility requirements and provides necessary documentation.
• Scan all registration materials into the practice management system.
• Check-in clients at the point of care. Verify/update all client demographic information at each visit including but not limited to eligibility for services. 
• Verify insurance for clients with upcoming appointments at least the day before. 
• Identify and assist any uninsured or underinsured clients who may be eligible for other health benefit programs. 
• Collect fees and co-payments from non-Indian clients prior to directing them to their appointment. 
• Post and reconcile payments in practice management system. Send payments with reconciliation report to finance daily. Keep cash box secure at all times.
• Process intake forms within five (5) working days of receiving. 
• Demonstrates knowledge of available health benefit programs.
• Meets one-on-one with clients to provide information on available health benefit programs and assess client eligibility parameters. Facilitate the coordination of client’s health information with the facility and with their insurance companies and other payers.
• Coordinates and utilizes an effective system of communication throughout UIHS, with caregivers, and external insurance agencies to complete application process for clients.
• Establish and maintain constructive working relationships. 
•  Tracks and prepares reports on the number of applications processed as well as number of incomplete applications pending additional information monthly and submit to the Member Services Specialist. . 
• Provides timely follow-up on the approval or denial of client applications. 
• Assists clients with clinic initiatives including Patient Portal sign up, distributing election forms, client experience surveys, etc.
• Participates in quality improvement activities as assigned.
• Prioritizes entry of family intakes for clients needing Purchased/Referred Care services.
• Note all significant client interactions in their electronic health file
• Maintain appropriate files and documents.
• Attend organizational committee meetings and other meetings as assigned.
• Maintain professional, organized, and clean working environment by following organizational policies, guidelines, and safety standards.
• Attends seminars or training sessions appropriate for maintaining up-to-date knowledge. 
• Answers telephone in a courteous and efficient manner. Gives information to callers or routes calls to appropriate person or section.
• Operates various office equipment including a photocopier, calculator, fax machine, computer, printer, and any other office equipment to perform tasks as needed.
• Must be willing to learn more about the American Indian culture and attend at least one Cultural Presentation/Training per year. 
• Must be willing to work with American Indian/Alaska Native people and demonstrate cultural awareness and humility 
• Must be willing to deliver services in a culturally responsive manner. 
• Adheres to accreditation and compliance standards/guideline
• Other duties may be assigned.

SUPERVISORY RESPONSIBILITIES:

QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. All individuals must demonstrate a commitment to the provision of culturally sensitive counseling services to American Indians.

EDUCATION/EXPERIENCE: Educational degrees must be from a US Department of Education accredited school

 Level I

COMPUTER OPERATIONS:

LANGUAGE SKILLS:

• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. 
• Ability to write routine reports and correspondence. 
• Ability to speak effectively before groups of customers or employees of organization.