File Clerk - Pbc (Dhpb17)

In accordance with Navajo Nation and federal law, TCRHCC has implemented an Affirmative Action Plan pursuant to the Navajo Preference in Employment Act. Pursuant to this Plan and corresponding TCRHCC Policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally-recognized American Indian Tribes will be given tertiary preference.

Position Summary

The primary purpose of this position is to perform a major segment of the accounts receivable management function to the Patient Accounts sections of the Medicare and Marketplace Sponsorship Program with Patient Benefit Coordination Department. This position requires the ability to work under conditions of frequent interruptions, be autonomous, collaborative and willingness to work a flexible schedule. Ensures applicable federal, state, local and organizational privacy laws and regulations are followed with issues related to Health information, confidentiality, release of information and patient rights. Works closely with Medicare Part D/ Marketplace enrollee.

Necessary Qualifications

Education

High School graduate or GED

Experience

• Experience working with various automated systems and Microsoft applications
• Must have one (1) year of experience working in an office environment

Other Skills and Abilities

A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each one of the following areas

• Reliable and dependable; reports to work as scheduled without excessive absences
• Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job
• Good oral and written skills and computer literacy for online enrollment assistance
• Must have and maintain an unrestricted current valid state driver’s license
• Successful completion of fingerprint clearance requirements, physical examinations, and other screenings indicating that the applicant is qualified to be employed by TCRHCC and demonstrating to the satisfaction of TCRHCC that the applicant can perform the essential functions of the job
• Completion of and above-satisfactory scores on all job interviews, demonstrating to the satisfaction of the interviewees and TCRHCC that the applicant can perform the essential functions of the job
• Strong organizational skills
• Ability to operate under immense pressure
• Submission of all required employment-related documents, applications, resumes, references, and other required information free of false, misleading or incomplete information, as determined by TCRHCC.
• Possession of high ethical standards and no history of complaints
• Positive working relationships with others; works effectively in team relationships

MENTAL AND PHYSICAL EFFORT

The physical and mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Physical

Work is mostly sedentary, must be able to continuously sit, stand, walk, drive, bend, twist, maintain balance, and reach as well as frequently kneel and crouch. The work may require the ability to frequently carry items such as books, papers, and related documents or files weighing up to 10 lbs. and occasionally push/pull up to 10 lbs. of items. Must be able to continuously perform simple grasping, firm grasping, and fine manipulation of both hands as well as use the keyboard. Sensory requirement for position includes far vision, near vision, color vision, depth perception, seeing fine details, hearing normal speech, hearing overhead pages and telephone use.

Mental

Must be able to prioritize and use good judgment; and be able to coordinate a variety of issues with intermittent interruptions. Must have ability to continuously cope with high levels of stress, make decisions under high pressure, cope with anger, fear, hostility of others in a calm way, concentrate, handle high degree of flexibility, work alone, demonstrate high degree of patience, adapt to shift work, and work in areas that are close and crowded. Must also have the ability to manage altercations frequently. Must accept a flexible schedule to meet unit needs.

Environmental

While in this position you may continuously be exposed to infectious diseases and occasionally to extremes in temperature or humidity and loud noises.

Essential Functions

• Performs other duties as assigned.
• Pulls and distributes patient benefit folders to the appropriate personnel.
• Handles all incoming mail and its distribution as well as all outgoing departmental mail.
• Complete task training for all routine cleaning and decontamination processes for all surfaces contaminated by a communicable disease to ensure a high level of patient, visitor, employee and external customer satisfaction.
• Assist Medicare Part D enrollee with MOU/PHI from incoming client/s and explain purpose of MOU/PHI in Navajo if client/s are not able to speak or understand English.
• Controls receipt of registration documents, explanation of benefits copies for placement in the patient benefit folder. Places materials into appropriate patient benefit folder.
• Handles the re-filing of all patient financial folders in the master file system.
• Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield.
• Locates patient financial folder needed to respond to correspondence received by Medicare Part D/Marketplace mailings and distributes to the appropriate staff.
• Copies and files remittance advice copies for government and state programs in patient financial folders.
• Responsible for the creation of patient financial file folders to be utilized in the business office for maintaining all financial information pertinent to each patient encounter or admission.
• Complete all donning and doffing tasks in a safe acceptable method and discard of used PPE accordingly. (see CDC website for most current updates)
• Responsible for the accurate maintenance of a centralized file system for patient benefit coordinator files in the business office. Maintain the central file system in an alpha sequence by patient name in a readily retrievable fashion.
• Conduct home visits for MOU/PHI signatures for client/s who are not able to travel.

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