Contact Representative
Contact Representative
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$ 21 - 25
1 Vacancy
Job Description
Closing Date: 06/30/25 @4:00pm (M.S.T)
Salary Range: $21.17-$25.62/hour
**APPLICANT MUST HAVE A VALID UNRESTRICTED INSURABLE DRIVERS LICENSE**
**RESUMES AND REFERENCES ARE REQUIRED**
ESSENTIAL DUTIES FUNCTIONS AND RESPONSIBILITIES
- Perform a variety of patient representative functions including completion of applications for alternate resources making home or hospital visits to interview patients arranging for transportation for patients interpreting alternate resources rules and regulations and interacting with all outreach programs to maximize eligibility information. Gather and record required information which includes screening for financial eligibility and confirming health insurance coverage. In addition data entry of updating demographic information.
- Obtain Prior Authorization from Third party payers for Radiology and Laboratory.
- Provide information on rights and benefits of multiple alternate resources serve as an advocate by personally intervening on the patients behalf to dispute and/or debate the case with multiple third-party resources.
- Follow up on pending applications working closely with families and various agencies involved on the concept that the patient is not discriminated against.
- Ensure timely entry of all private insurance all state Medicaid and Medicare information to augment outpatient and inpatient billing efforts.
- Provide assist educate and work collaboratively by maintaining an effective communication and referral system with patients internal departments healthcare
providers and external healthcare facilities including all various tribal state and/or federal public assistance programs. - Identify and pre-certify those patients whose health benefits are subject to prior approval to determine the extent of the health care for both inpatient and outpatient billing efforts.
- Ensure timely updates by working closely with the Utilization Review and Patient Registration on the specifics of obtaining pre-certification of a patient. Participates in discharge planning and utilization review projects and/or meetings.
- Initiate and provide an efficient enrollment process with various specialized programs; Navajo Aids Network Social Security Administration Federal Marketplace Extra Help etc.; screening potential patients and communicating with healthcare providers and all involved programs.
- Maintain a statistical tracking system by keeping daily and monthly activities report of processed applications; (pending denials and general assistance applications).
- Provide reports of entail comparison with explicit eligibility criteria process of the outpatient and inpatient billing efforts. Establish a continuous research of reports by updating of information involving changes in rules and regulations for Medicare and Medicaid enrollment programs.
- Performs other duties as assigned.
Experience:
Three (3) years experience with Electronic Health Records Resource Patient Management System (ADT)/VISTA and Change Healthcare in providing health benefit coordination; interviewing patients determining eligibility for various types of resource benefits and verifying insurance information.
and
One (1) year experience of Patient Registration scheduling screening and customer service experience in a hospital or medical office setting.
Education:
High School Diploma or High School Equivalent (HSE).
Please email degree or transcripts to
NAVAJO/INDIAN PREFERENCE:
FDIHB and its facilities are located within the Navajo Nation and in accordance with Navajo Nation law has implemented a Navajo/Indian Preference in Employment Policy. Pursuant to this Policy applicants who meet the minimum qualifications for this position and who are enrolled members of the Navajo Nation will be given primary preference in hiring and employment for this position and members of other federally recognized Indian tribes will be given secondary preference. Other candidates will be considered only after all candidates entitled to primary or secondary preference have been fully considered.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
