Member Services Coordinator II, Spanish

Native American Health Center Inc; Oakland (CA); On-site; USD 36,000 - 42,000; Full time

Benefits offered by this job

Medical Insurance

Vision Insurance

Dental Insurance

403(b) Retirement Plan

Flexible Spending Account

Paid Time Off

Job summary

Native American Health Center (NAHC) in Oakland, CA is seeking a bilingual Member Services Coordinator II to assist members with accessing services, enrolling in public programs, and navigating insurance benefits across Medical, Dental, and Mental Health departments. The role requires an Associates degree or equivalent experience, fluency in English and Spanish, and proficiency with clinic software.

It is a full-time, 40-hour/week position supporting enrollment, data entry, and high-volume

Qualifications

• Associates Degree or 2 years’ experience as medical or dental receptionist/registrar.
• Fluency in English and Spanish (written and spoken) required.
• Certified Enrollment Counselor and/or Certified Application Counselor certification required or within 90 days.
• Knowledge of clinical treatment procedures and terminology.
• Experience with an electronic health/dental record system and practice management system preferred.
• Proficiency in Microsoft Office and typing ≥30 WPM.
• Knowledge of private insurance eligibility and funding sources.
• Strong communication, teamwork, and multitasking abilities.
• Ability to work in fast-paced, high-volume environments.

Responsibilities

• Greet members and maintain a welcoming atmosphere.
• Schedule appointments and manage calls and inform members of processes.
• Proactively manage and optimize appointment scheduling to maximize productivity.
• Manage voicemail system and route messages appropriately.
• Inform members of insurance, benefits, and co-pays.
• Assist with enrollment in public programs and coordinate private insurance benefits.
• Enter payer codes and update PMS records with accuracy.
• Provide language translation assistance as needed.
• Support quality improvement initiatives within NAHC.

Skills

Fluent English & Spanish

Communication skills

Team player

Multitasking

Independent judgment

Education

Associates Degree or 2 years’ experience

Tools

Electronic health record system

Practice management system

Microsoft Office Suite

Job description

Job Details

Job Location: 7 Directions 2950 Oakland - Oakland, CA 94601Position Type: Full TimeEducation Level: 2 Year DegreeSalary Range: $26.05 - $30.71 HourlyTravel Percentage: Up to 25%Job Shift: DayJob Category: Admin - ClericalPOSITION: Member Services Coordinator II, Spanish DEPARTMENT: Member Services LOCATION: Native American Health Center (NAHC) - All Locations 2950 International Blvd, Oakland, CA 94601 WORK HOURS: Full Time, 40 hours per week, 100% FTE STATUS: Union, Non-Exempt

Position Summary

The Member Service Coordinator II (MSC II) works as a part of a multi-disciplinary teamof individuals who provide high quality member care. The MSC II must be able to acceptand adhere to guidance and direction from multiple levels of management. The MSC IIwill work with members to identify appropriate funding sources that may cover the costof treatments and enroll members in publicly-funded programs to determine fees andco-payments as needed. This position requires knowledge of clinical terminology andtreatments and is responsible for assisting members with accessing services withinNAHC Medical, Dental, and Mental Health Departments. The MSC II will assist withmember account review and will assist in training and support of other MSC within theMember Services Department.

DUTIES AND RESPONSIBILITIES

1. Greet all members in a courteous and professional manner to create andmaintain a welcoming atmosphere.
2. Schedule member appointments appropriately, answer and return telephonecalls in a timely manner, and inform members of processes and procedures.
3. Proactively manage and “tetris” appointment scheduling to maximize productivityand to fill appointment gaps.
4. Manage the voicemail system, which includes: create and update greetings asappropriate; check messages often and ensure messages are routedappropriately and activate the voice message system at appropriate times.
5. Make member appointment reminder calls the day prior to the appointment toconfirm, and notify members of any outstanding balances on their accounts.
6. Answer member inquires about financial responsibility, insurance and benefits,account status, and treatment planning.
7. Receive and deliver messages to providers, ensure all stakeholders are aware ofschedule changes, distribute member appointment schedules daily, preparecharts/documents, and inform the provider of outstanding payments that pertainto services requiring payment i.e. Dental Labs.
8. Register members into the practice management system (PMS) in a manner thatensures accuracy and thoroughness and update member registration informationonce per year at minimum, or as information changes. Inform members of Noticeof Privacy Practices and obtain the members signed acknowledgementstatement.
9. Register members into NAHC member portal. Provide user support andeducation on portal functionality.
10. Manage NAHC member portal appointment request and member messages.
11. Screen members’ eligibility for possible care coverage (e.g., county or stateprograms; sliding scale.) Inform members of program limitations and ensuremember understands the information being conveyed.
12. Enroll members into appropriate publicly-funded programs and follow enrollmentand program guidelines. Coordinate private insurance benefits with the memberand the provider.
13. Responsible for entering accurate assigned payer codes in (PMS), enteringexpiration dates according to guidelines, terminating inactive payer codes, andselect appropriate payers codes for services.
14. Follow NAHC procedures when collecting payments from members and issue areceipt every time. Inform appropriate staff of payment status.
15. Confirm members’ insurance eligibility on all scheduled appointments at least twodays prior to scheduled appointments. Notify members in a timely manner ofchanges to insurance benefits.
16. Coordinate Private Insurance benefits with the member and the provider by;verifying coverage/benefits, limitations, waiting periods, pre-authorizations, andfinancial responsibility.
17. Check-in members for their scheduled appointments in a timely manner andcomplete all flows for the member appointment such as; verifying memberdemographics, processing payments, insurance verifications, payer codeselection, printing encounter labels, and pulling charts as appropriate.
18. Conduct member financial screenings to determine their eligibility for CountyMedical Services Program (LIHP/ACE); Medicare; Medi-Cal; Healthy Families;State Office of Family Planning (SOFP); Presumptive Eligibility; Alameda Alliancefor Health-AAH Family Care; and other payment sources.
19. Use OneEapp/CalHeers/Covered CA Portals as a means to determine eligibilityand enroll into eligible programs.
20. Provide Covered CA education on available plans/metal tiers clients are eligibleto enroll in.
21. Follow all enrollment criteria, eligibility rules/requirements, and maintaincertification of any and all Federal, State, County health programs NAHC isrequired to follow.
22. Assist members with completing forms and applications for various paymentprograms.
23. Create and review member account alerts and flags for account status, identifying programs, service locations, treatment related notations, banned member status, etc.
24. Participate in Saturday clinics and after-hour clinics, on a rotating basis, asassigned by Supervisor.
25. Document member contact by telephone, in person, by mail as appropriate inelectronic health record.
26. Log and reply in a timely manner to health record requests for chart notes,radiograph copies, lab results and ensure they are compliant with HIPPA policiesand procedures.
27. Respond in a timely manner to Billing department inquires; answer necessarytreatment-related Billing questions and correct MIRs (Missing InformationRegistration) and return in a timely manner, and assist in the process ofcorrecting MID/MIM (Missing information Dental/Medical) encounters.
28. Assist in the quality assurance and timely submission of encounter forms, as requested.
29. Assist with language translation as needed for healthcare services.
30. Actively participate in internal quality improvement teams to drive initiatives inaccordance with the mission and strategic goals of the organization.
31. MSC’s are assigned appropriate duties as it relates to specific sites, programs,and departments. These duties may include data entry, maintaining logs, generating reports, invoicing for payments and grants, ordering supplies,scheduling pick-ups and deliveries, maintaining active/inactive charts, sort mail,attend meetings, assisting in audits, and supporting satellite clinics.
32. Member Care: Demonstrate understanding and apply working knowledge ofsafety policies and ensuring safe member practices.
33. Employee Safety: Safely performs all duties; follows required protective protocolsto ensure personal safety as well the safety of others.
34. Must maintain compliance with ergonomic safety standards; be mindful ofposture and regularly practice ergonomic stretches.
35. Actively participate in internal quality improvement teams and work withmembers proactively to drive quality improvement initiatives in accordance withthe mission and strategic goals of the organization, federal and state laws andregulations, and accreditation standards, when assigned.
36. Work well under pressure, meet multiple and often competing deadlines.
37. At all times demonstrate cooperative behavior with supervisors, subordinates,colleagues, clients and the community.
38. Other duties as assigned by Supervisor.

Qualifications

1. Associates Degree, or 2 years’ experience working as a medical or dental receptionist or registrar.
2. Fluency in both English and Spanish, both written and verbal, is required, per operational need.
3. Certified Enrollment Counselor and/or Certified Application Assistor Certification is required, or must be obtained within 90 days of employment.
4. Must have knowledge in clinical treatment procedures and terminology.
5. Experience using an electronic health/dental record system and practice management system is desired.
6. Must be proficient at Microsoft Office Suite, and be able to type at least 30 WPM.
7. Knowledge of private insurance eligibility and benefits and various state and county funding sources is desired.
8. Must be a team player, and have superior communication skills – verbal and written.
9. Must be able to work well in extremely fast-paced environments and in high volume situations, and be able to multi-task.
10. Have the ability to work independently and exercise sound judgment and be ableto make decisions appropriate to scope of authority and practice.

Benefits

Native American Health Center (NAHC) considers our employees to be our most valuable resource and offers anexcellent benefit package: competitive salaries, personal time off (PTO) or sick/vacation leave program, and anemployer contribution 403(b) retirement plan to full-time regular status employees. We also provide medical, vision,dental, flexible spending, group term and voluntary life insurance coverage for employees and their dependents—with a percentage of employee contribution for dependent medical premiums.

Note to Applicants

Please be advised a post job offer, pre-employment Physical and TB test are required as a condition of employment. Additionally, you may be asked to get a Department of Justice Fingerprinting clearance as a contingency for an offerof employment. Criminal clearances are obtained to protect the welfare and safety of clients receiving services atNAHC.

EQUAL OPPORTUNITY EMPLOYER

Within the scope of Indian Preference, all candidates will receive equal consideration without regard to race, color, gender, religion, national origin or other non-merit factors.

Age Discrimination in Employment Act (ADEA): Native American Health Center abides by the mandates of the ADEA (protecting individuals 40 years and older) and considers age a non-merit factor in all employment decisions and considerations.

Americans with
Disabilities Act (ADA): Native American Health Center abides by the mandates of the ADA and considers disability a non-merit factor in all employment decisions and considerations. Furthermore, NAHC will make any practical, feasible, and reasonable arrangements to accommodate qualified applicants and employees with disabilities.