POSITION SUMMARY:
As a part of the Patient Services branch of Administration, this position is responsible for a wide range of registration and eligibility services including but not limited to patient registration, Native American verification, and other enrollment services, and advocacy. Patient Services Specialist works in conjunction with the Patient Services Coordinator and FRTH staff to assist in obtaining documentation to establish eligibility for FRTH services including Purchased/Referred Care.
ESSENTIAL FUNCTIONS:
- Patient Registration and Intake Services - Provides comprehensive patient registration services at all sites, including direct, ineligible, and Purchased/Referred Care (PRC) patients. Registers patients in accordance with Indian Health Service (IHS) and Feather River Tribal Health (FRTH) policies and procedures. Ensures accurate data entry and maintenance of patient records in the electronic health record system in an organized and retrievable manner. Ensures compliance with California Department of Corrections and Rehabilitation (CDCR) program guidelines as applicable.
- Eligibility Determination and Health Coverage Assistance - Determines patient eligibility for services under supervision and assists patients in identifying health insurance options. Enrolls patients in Covered California, Medi-Cal, and premium sponsorship programs on an as-needed basis and supports them in accessing available health benefits.
- PRC Coordination and Compliance - Collaborates with PRC staff to register PRC patients per agency and IHS policies, monitor eligibility, manage suspensions, and assist with appeals. Ensures PRC data is current and accurate.
- Documentation and Verification Support – Assists patients with obtaining required documentation from Tribal and other government agencies. Provides guidance on researching family trees and obtaining Indian Verification as needed.
- Cross-Departmental Collaboration and Referrals - Coordinates with internal departments and FRTH staff to refer patients for additional services or eligibility resources, ensuring seamless access to care and support programs.
- Tribal Liaison and Community Engagement - Acts as a liaison with sponsoring tribal programs to support the healthcare needs of Native American communities, facilitating culturally competent care and communication.
- Satellite Facility Support - Assists satellite facility staff with patient registration processes and ensures consistent registration procedures across all locations.
- Reporting and Data Quality Management - Generates and analyzes reports to identify discrepancies and ensure accurate registration and PRC records. Works proactively to update and correct data in collaboration with relevant departments. Inactivates patients in accordance with FRTH criteria to maintain the integrity of active patient records.
ADDITIONAL RESPONSIBILITIES:
- Performs other related duties as assigned to support departmental and organizational goals.
- Attends all required trainings, meetings, and conferences to maintain current knowledge of policies, procedures, and best practices.
- Participates in special projects and prepares reports as requested, including those related to accreditation, audits, and quality improvement initiatives.
- Assists with various administrative or operational tasks as needed to ensure efficient department workflow and service delivery.
- Learns and implements evolving functionalities within the electronic health record system to support improved efficiency, documentation, and patient care coordination.
KNOWLEDGE, SKILLS AND ABILITIES:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:
- Demonstrates a professional attitude, appearance, and pleasant demeanor at all times. Maintains a positive attitude and strong human relation skills to interact effectively with patients, clients, staff, Board members, community members, and visitors in person and by phone. Possesses the ability to de-escalate tense situations and respond calmly and appropriately to angry or distressed patients in a respectful and solution-focused manner.
- Exhibits awareness, sensitivity, and appreciation of Native American culture, traditions, customs, and socioeconomic needs.
- Possesses the ability to communicate and write clearly, concisely, and effectively across diverse audiences.
- Proficient in operating modern office equipment including point-of-sale systems, copiers, fax machines, computers, and internet-based tools. Able to use electronic health records and other relevant software to perform job duties accurately and efficiently.
- Able to manage multiple responsibilities, meet deadlines, and adapt to stressful situations and time constraints while maintaining quality and efficiency.
- Capable of working independently on a variety of tasks while also contributing positively to a team environment. Maintains effective working relationships with both internal staff and the public.
- Possesses basic knowledge of Medi-Cal, Medicare, PRC, and other third-party insurance and sponsorship resources relevant to patient eligibility and registration functions.
EDUCATION AND EXPERIENCE:
- High school graduate or GED equivalent.
- Two (2) years’ experience in clinical software and applications support in the healthcare industry, NextGen experience preferred.
- At least two (2) years’ experience in patient/customer relations, insurance enrollment processes and patient registration/front office; PRC experience preferred.
PHYSICAL REQUIREMENTS:
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. Reasonable accommodations may be made to enable individuals with disability to perform the essential functions.
While performing the duties of this job, the employee is regularly required to use hands to finger, handle or feel; reach with hands and arms, stoop, kneel or crouch; and talk and hear within normal range. The employee is frequently required to stand, walk, sit, climb, or balance and use taste and smell senses. The employee must regularly be able to lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus. This position is physically and emotionally challenging. There is a high degree of stress. Ability to deal with time constraints and emotional stress are also essential functions of this job.
Compensation & Benefits:
Hourly Rate: $26.13- $27.19, depending on experience
Health Insurance: Employer-paid medical coverage starting the month after hire for all tiers — Self, Self + One, and Self + Family
Dental & Vision: 100% employer-paid for employee-only coverage; additional family coverage available at a competitive rate
401(k) Plan: Available immediately upon hire with a 3.5% employer match
Life Insurance: $20,000 employer-paid policy for full-time employees, with options to purchase additional coverage
Paid Time Off: Vacation begins accruing on your first day — up to 80 hours annually
Loan Repayment Assistance: Available to qualifying employees
