Patient Benefits Coordinator

Klamath Tribal Health; Chiloquin (OR); On-site; USD 25,000 - 44,000; Full time

Benefits offered by this job

Full Benefits

Job summary

Klamath Tribal Health seeks a Patient Benefits Coordinator to help patients access Medicaid, Medicare and Tribal programs while guiding enrollment and eligibility processes. You will coordinate with front-line staff and document activities in the EHR/PM system.

The role emphasizes assisting families, maintaining up-to-date patient data, and empowering patients to utilize available health resources. A valid driver’s license and certifications are required.

Qualifications

• High School Diploma or Equivalent required; submit diploma or transcripts.
• Minimum 1 year of experience in customer service, admin support, data entry or related field.
• Must obtain Oregon Health Plan assister certification within 90 days of hire.
• Must obtain SHIBA certification within 9 months of hire; valid Oregon Driver’s License required.

Responsibilities

• Determine eligibility of referred patients and document actions within three working days.
• Collaborate with Patient Registration, Third Party Billing and other staff to ensure accurate information and utilization of alternate resources.
• Back up for Patient Registration and assist in maintaining patient data in the EHR/PM system.
• Ensure maximal identification of eligible patients for alternate resources.
• Assist patients with applications for Medicaid/Medicare and explain rules and coverage.
• Transmit applications to agencies and track processing, documenting activities in notes and logs.

Skills

Communication

HIPAA compliance

Data entry

Tribal program knowledge

Interviewing

RPMS proficiency

Education

High School Diploma or Equivalent

Tools

MS Word

MS Excel

RPMS system

Job description

Description

OPENED: 10/09/2026

CLOSE: 10/26/2026

POSITION DESCRIPTION

POSITION: PATIENT BENEFITS COORDINATOR

RESPONSIBLE TO: Patient Services Manager

SALARY: Step Range: 9 ($17.80) - 28 ($31.21); Full Benefits

CLASSIFICATION: Non-Management, Full-Time, State Funded

LOCATION: Klamath Tribal Health & Family Services

Healing Place, Klamath Falls, Oregon and/or

Medicine Place, Chiloquin, Oregon

BACKGROUND: P.L. 101-630 Level

POSITION OBJECTIVES

The primary purpose of this position is to function as an advocate for patients in the effective utilization of alternate resources such as Medicare, Medicaid, Department of Veterans Affairs (DVA), Bureau of Employment Compensation (BEC), Private Insurance Billing (PIB, Children’s Special Health Services, Aid to Families with Dependent Children (AFDC), Oregon Health Plan, etc. The primary responsibility of this position is to ensure that all patients who are eligible for alternate resources are identified, contacted and encouraged to apply for and maintain eligibility for available benefits.

MAJOR DUTIES AND RESPONSIBILITIES

1. Determine eligibility of patients referred to by Klamath Tribal Health & Family Services’ staff. Provide a response describing initial action taken to the referring staff within three working days upon receipt of referral. Maintain chart notes within the EHR/PM Patient Benefits Notes section and Alternate Resource Master Log documenting all actions taken regarding referral

2. Work closely with Patient Registration, Third Party Billing, Contract Health Services and other front-line staff to ensure all patient information is current, accurate and that all alternate resources are utilized.

3. This position will provide back up for Patient Registration and assist in maintaining current and accurate patient data in the database being utilized by Klamath Tribal Health. This will involve interviewing and screening new and existing patients and informing Patient Registration staff so that the appropriate changes can be made. The Patient Benefits Coordinator may make the changes with approval from the supervisor.

4. Ensure maximal identification of persons who have or are eligible for alternate resources by effectively implementing screening and interview methods.

5. Work closely with all facility staff in identification and proper utilization of all alternate resources available to all patients who utilize Klamath Tribal Health & Family Services, giving emphasis to those who reside in the Klamath Tribes’ Health Service area (Klamath County). Alternate Resources are those that provide direct health assistance for the client, for example Medicaid and Medicare.

6. Assist patients and their families with processing all applications for alternate resources, for example Medicaid and Medicare. Provide interpretation of the rules and regulations from the organization supplying the benefit, as well as the rules governing Tribal/IHS services. Review with patients what is covered and how to use those services. This may require occasional travel to the patient’s home to acquire documentation, assist with applications or to interview the patient for additional information.

7. Transmit all applications for alternate resources to the appropriate agency; track and monitor the processing of applications. Document all activities within the EHR/PM Patient Benefits Notes section and Alternate Resource Master Log.

8. Track all applications for alternate resources throughout the processing period. Follow up to ensure all required information and documentation have been submitted, monitor application status and renewal/end dates, and take timely action to prevent missed deadlines or lapses in coverage. The Patient Benefits Coordinator will contact the patient following application submission to identify and obtain any additional information or documentation needed to complete the application process. Document all follow-up attempts, communications, and actions taken in accordance with department procedures.

9. Follow up on all pending eligibility claims and work closely with families and agencies to see that patients are not discriminated against because of their dual role as a citizen and as a Tribal Health/IHS recipient.

10. Keep patients and staff up to date on regulatory changes by researching, updating and sharing information on alternate resources.

11. Document all work activities on finding/maintaining/assisting with alternate resources on the “notes page” of the patient’s chart in the current database system being utilized by Klamath Tribal Health.

12. Develop and maintain a network of contacts in local, state and federal agencies to better assist patients in developing other resources, including all agencies and organizations that provide alternate resources for health care. Identify a contact at the agency who can assist the patient with detailed applications for Social Security Administration (SSA), Department of Human Services Tribal programs AFDC, Supplemental Social Security Income (SSI), etc.

13. Responsible for maintaining an accurate daily log of activities; log of visits with patients noting the chart number, the time and what action was taken, (i.e. home visit to complete application, advocate work at the local DHS office, etc.); submit log to Patient Services Manager for review each week.

14. Assist clients with initial applications for disability determination through the Social Security Administration by providing information on how to apply online, by mail or in-person. Staff may also assist the client in making contact with an agency or individual of their choice who specializes in disability assistance.

15. Assist clients in enrolling into health insurance plans through Oregon’s state-based marketplace.

16. Submit monthly and annual reports to the Patient Services Manager. Submit quarterly reports to the Office of Medical Assistance Programs as agreed to by contract

17. Assist patients eligible for KTHFS Tribal Premium Sponsorship Programs with applications for enrollment, relay information regarding program eligibility, and program benefits.

18. Screen upcoming KTHFS appointments (Medical, Dental, YFGC, etc.) daily, as assigned by the Patient Services Manager, to verify active health insurance coverage or potential eligibility for alternate resources for those who are uninsured. Place appropriate alerts in the patient’s chart and make reasonable efforts to screen the uninsured patients for potential alternate resources. Document screening efforts and outcomes in the patient’s EHR/PM notes section.

18. Attend meetings, trainings, and other professional development opportunities hosted by external collaborative entities when requested by Patient Services Manager.

19. Like all employees of the Klamath Tribes, the incumbent will be called upon to accomplish other tasks that may not be directly related to this position, but are integral to the Klamath Tribes’ broader functions, including but not limited to, assisting during Tribal sponsored cultural, traditional, or community events that enable the successful operation of programs and practices of The Klamath Tribes as aligned with The Klamath Tribes’ Mission Statement. Some of these tasks may be scheduled outside of regular work hours, if necessary.

SUPERVISORY CONTROLS

The Patient Benefits Coordinator works under the direct supervision of the Patient Services Manager. Assignments are performed according to various established office procedures using set standards. New assignments are provided in detail, as well as changes in current procedures. Major or new issues are referred to supervisor. Work is checked for accuracy, adequacy, and timeliness.

After initial training, recurring assignments are completed independently. Completed work is spot checked for accuracy, adequacy and timeliness, and compliance with policies and procedures.

KNOWLEDGE, SKILLS, ABILITIES

Knowledge of and the ability to maintain strict confidentiality of medical and administrative records adhering to the standards for health record-keeping under HIPAA and Privacy Act requirements.

A working knowledge of Medicare/Medicaid, SSA, DSS and Tribal programs and other related agencies policies and procedures to assist patients in application for alternate resources.

Knowledge of the eligibility requirements for Medicare/Medicaid, SSI, OHP, in order to determine who is eligible for alternate resources.

A working knowledge of sensitivity communication practices and interview techniques in order to speak with and for the patient.

Possess basic knowledge of how to establish registers of eligible patients in various programs to determine who is eligible for alternate resources.

Knowledge of required formats and various documents maintained by Klamath Tribal Health & Family Services from both internal and external sources to compile and produce various reports. This includes the ability to review a variety of schedules and analyze data reports.

Able to ensure good public relations by maintaining a cooperative and considerate attitude toward others.

Must possess the ability to follow directions and absorb data necessary to efficiently perform assigned duties and responsibilities.

Must have the ability to function well under the pressure of meeting deadlines in difficult situations. The work consists of duties that involve different and unrelated processes and methods. Frequently involves establishing the eligibility of patients with uncooperative outside agencies and assisting in settling controversial issues.

Must be willing to go to patients’ homes to interview and collect information. This will require eligibility to KTHFS’ vehicle insurance and the ability to drive in inclement weather.

Must be proficient in typing and computer skills. Emphasis will be on accuracy and attention to detail. Ability to use IBM compatible PC, MS Word, MS Excel, MS Office, and ability to learn RPMS program necessary for data tracking.

Ability to maintain strict confidentiality of medical records and adhere to the standards for health record-keeping, HIPAA and Privacy Act requirements.

QUALIFICATIONS, EXPERIENCE, EDUCATION

Minimum Qualifications: Failure to comply with minimum position requirements may result in termination of employment.

• REQUIRED to possess a High School Diploma or Equivalent. (Must submit copy of diploma or transcripts with application.)
• REQUIRED to have a minimum of one (1) year of experience in customer service, administrative support, data entry, or a related field involving direct interaction with the patients, participants, vendors and the public.
• REQUIRED to obtain and maintain Oregon Health Plan assister certification within 90 days of hire.
• REQUIRED to obtain and maintain SHIBA (Senior Health Insurance Benefits Assistance) certification within 9 months of hire
• REQUIRED to possess and maintain a valid Oregon Driver’s License, (out of state applicants must receive ODL within 90 days of hire), have good driving record and be insurable by the Klamath Tribal Health & Family Services’ vehicle insurance policy. (Must submit copy of driver license with application.)
• REQUIRED to acquire and maintain BLS certification within 180 days of hire; strongly recommend certification within 90 days of hire, probationary period will be extended for a maximum of 180 days pending certification.
• REQUIRED to have excellent communication skills; understanding of Tribal services, alternate health resources and service terminology.
• REQUIRED to drive in adverse weather conditions.
• REQUIRED to maintain strict patient confidentiality and adhere to the standards for behavioral health record-keeping and HIPAA requirements.
• REQUIRED to have recordkeeping skills with the ability to complete required documentation and required written follow-up.
• REQUIRED to submit to a background and character investigation, as per Tribal policy. Following hire must immediately report to Human Resource any citation, arrest, conviction for a misdemeanor or felony crime.
• REQUIRED to submit to annual TB skin testing and adhere to KTHFS staff immunization policy in accordance with the Centers for Disease Control immunization recommendations for healthcare workers.
• REQUIRED to accept the responsibility of a Mandatory Reporter in accordance with the Klamath Tribes Juvenile Ordinance Title 2, Chapter 15.64 and General Council Resolution #2005 003, all Tribal staff are considered mandatory reporters.
• REQUIRED to travel between Healing Place in Klamath Falls and the Medicine Place in Chiloquin, as needed.

Preferred Qualifications:

• Three (3) years experience working in a medical office is preferred.
• Experience working with Native American programs is preferred.
• Experience working with medical/records management is preferred.
• Experience working with health insurance benefits is preferred.

Indian Preference:

Indian and Tribal Preference will apply (Must submit tribal documentation with application to qualify for Indian Preference).

In accordance with Klamath Tribal policy, priority in selection will be given to qualified applicants who present proof of eligibility for “Indian Preference”.

ACKNOWLEDGEMENT

This position description is intended to provide an overview of the requirements of the position. It is not necessarily inclusive and the job may require other essential and/or non-essential functions, tasks, duties, or responsibilities not listed herein. Management reserves the sole right to add, modify, or exclude any essential or non-essential requirement at any time with or without notice. Nothing in this job description, or by the completion of any requirement of the job by the employee, is intended to create a contract of employment of any type.