3rd PARTY MEMBER BENEFITS TECHNICIAN

LAKE COUNTY TRIBAL HEALTH; Lakeport (CA); On-site; USD 36,000 - 48,000; Full time

Job summary

Lake County Tribal Health in Lakeport, California, is seeking a 3rd Party Member Benefits Technician to help native patients access benefits and complete enrollment applications.

You will maintain patient records, assist with forms and authorizations, coordinate with providers, and support data reporting for program expenditures. Applicants should have a HS diploma and strong Excel skills, plus experience in healthcare or benefits programs.

Qualifications

• High School Diploma.
• 1 year of admin, customer service, healthcare, or benefits-related experience preferred.
• Working knowledge of Medicaid, Medicare, private insurance, or healthcare benefit programs preferred.
• Strong computer skills, including proficiency with Microsoft Excel and other office software.
• Excellent organizational skills and attention to detail.
• Ability to communicate effectively with diverse populations, including Native American communities.
• Ability to maintain confidentiality and handle sensitive information appropriately.
• Experience using healthcare information systems, electronic health records, or benefit management software preferred.
• All LCTHC employees are expected to promote teamwork and abide by policies.

Responsibilities

• Assist eligible patients with enrollment applications for 3rd party benefit programs.
• Serve as a point of contact for patients regarding benefit applications and program participation.
• Maintain accurate patient records related to 3rd party benefit programs.
• Assist with preparation and submission of forms, authorizations, invoices, and supporting documentation for benefit payments.
• Help patients navigate resources and understand program requirements.
• Coordinate with healthcare providers, staff, patients, and external agencies for benefit activities.
• Maintain spreadsheets and databases tracking patient benefits, utilization, and program expenditures.
• Support implementation of policies related to benefit programs and communicate issues to supervisors.
• Other duties as assigned.

Skills

Attention to detail

Strong communication skills

Confidentiality

Teamwork

Education

High School Diploma

Tools

Microsoft Excel

Electronic health records (EHR) systems

Benefit management software

Job description

TITLE: 3rd PARTY MEMBER BENEFITS TECHNICIAN

DEPARTMENT:PRC

SUPERVISED BY:3rd PARTY MEMBER BENEFITS COORDINATOR

CLASSIFICATION: FULL-TIME NON-EXEMPT

POSITION SUMMARY:

The 3rd Party Member Benefits Technician ensures our native patients receive optimal care by managing their benefits effectively.

ESSENTIAL JOB FUNCTIONS:

• Benefit Enrollment Support: Assist eligible patients with completing enrollment applications for various 3rd party member benefit programs available through LCTHC. Gather required documentation, verify information for completeness, and enter enrollment data into appropriate systems.
• Patient Assistance and Customer Service: Serve as a point of contact for patients regarding benefit applications, eligibility requirements, and program participation. Provide general information about available benefits and refer complex questions or concerns to the Benefits Coordinator or PRC Manager.
• Documentation and Record Maintenance: Maintain accurate and organized patient records related to 3rd party benefit programs, including applications, authorizations, payment records, service dates, and supporting documentation. Assist with data collection and report preparation as requested.
• Benefit Processing Support: Assist with the preparation and submission of required forms, authorizations, invoices, and supporting documentation necessary for benefit payments and program participation. Monitor pending items and follow up as directed.
• Patient Advocacy and Resource Navigation: Assist patients and families in accessing available resources and understanding benefit program requirements. Provide guidance on obtaining necessary documentation and completing required processes to maintain eligibility.
• Communication and Coordination: Coordinate with healthcare providers, administrative staff, patients, and external agencies to facilitate benefit-related activities. Maintain professional and positive relationships with community partners and service providers.
• Data Tracking and Reporting: Maintain spreadsheets, databases, and tracking systems related to patient benefits, utilization, and program expenditures. Provide accurate information and reports to the Benefits Coordinator, PRC Manager, and other leadership as requested.
• Program Support: Assist with implementing established policies and procedures related to benefit programs. Identify operational issues and communicate concerns or recommendations to the Benefits Coordinator or PRC Manager.
• Other duties as assigned.

EDUCATION, EXPERIENCE, CERTIFICATIONS AND LICENSES:

• High School Diploma
• One (1) year of administrative, customer service, healthcare, or benefits-related experience preferred.
• Working knowledge of Medicaid, Medicare, private insurance, or healthcare benefit programs preferred.
• Strong computer skills, including proficiency with Microsoft Excel and other office software.
• Excellent organizational skills and attention to detail.
• Ability to communicate effectively with diverse populations, including Native American communities.
• Ability to maintain confidentiality and handle sensitive information appropriately.
• Experience using healthcare information systems, electronic health records, or benefit management software preferred.
• All LCTHC employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the LCTHC policies and procedures as they may from time to time be updated.

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Sitting / Mobility: Approximately 70% of time is spent working at a desk. Balance of time (approximately 30%) is spent moving around work areas. Communication: Ability to effectively communicate with co-workers, Board members, members of outside agencies, in person, by telephone, and by email. Vision: Ability to effectively use a computer screen and interpret printed materials, memos, and other appropriate paperwork. Lifting / Carrying: Ability to occasionally lift and/or move objects weighing no more than 25 pounds. Stooping / Kneeling: Ability to access files/stock supplies in low cabinets and shelves. Reaching / Handling: Ability to input information into computer systems and retrieve and work with appropriate paperwork, equipment, and supplies. Use of standard office equipment, including computer, telephone, calculator, copiers, and fax. Work is performed in an office/clinic environment; continuous contact with other staff and the public.

INDIAN PREFERENCE:

Preference may be given to qualified Native American Indians according to the Indian Preference Hiring Act, CFR 25 USC 472. Other than Indian Preference, Lake County Tribal Health Consortium, Inc. adheres to all provisions of the Equal Employment Opportunities Act.

NOTICE OF DRUG-FREE WORKPLACE ACT REQUIREMENT:

LCTHC is committed to maintaining a drug free and alcohol free workplace. LCTHC believes that a healthy, productive workforce free from the effects of drugs is very important to all employees and patients. Substance abuse is incompatible with the health, safety, efficiency and the success of LCTHC. Employees who are under the influence compromise LCTHC’s interests, endanger their own and the health and safety of others and can cause a number of other work-related problems. As a condition of employment, each applicant receiving a job offer from LCTHC must take and pass a required drug screen test.

HIPAA Health Insurance Portability and Accountability:

• Security of health information
• Standards of electronic transactions
• Privacy of individually identifiable health information

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Lake County Tribal Health is an At-Will Employer. Either the employee or LCTHC can terminate the employment at will, without advance notice, at any time, with or without cause.