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.

Requirements

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.

***Cover letter of interest and resume required with application. ***

Benefits