This full-time position is based at the Little Axe Health Center within the AST Purchased Referred Care Services Division. The role serves as a liaison between Absentee Shawnee Tribal Health, tribal members, and third-party healthcare providers. It focuses on processing CMS-1500 professional claims and UB hospital claims, reviewing and entering claims data into the Plexis database, generating purchase requests for payment, verifying insurance coverage, and ensuring member enrollment and CDIB documentation are current.
The position also supports coordination of benefits submissions, manages member profiles and related documentation, responds to PRC inquiries, and helps maintain accurate records for billing, vendor invoices, and denials.
High school diploma or GED.
At least 3 years of experience in a medical or business office setting.
Preferred:
- Experience as a medical claims processor
- Knowledge of explanation of benefits (EOB) from primary insurance
- Training or coursework in medical office billing/coding or a related field
- Experience with electronic health record (EHR) software
Other qualifications:
- Computer literacy and strong computer skills
- Excellent communication, negotiation, and customer service skills
- Ability to manage multiple complex situations and prioritize work independently
- Knowledge of software used to access and interpret patient data
- Ability to communicate effectively with patients, families, caregivers, and healthcare professionals
- Cultural sensitivity to Native Americans
- Strong organizational and assessment skills
- Ability to work as part of a team with minimal supervision
- Valid Oklahoma driver’s license
- Ability to pass a background check and drug screen
- Ability to perform sedentary office work and occasional lifting up to 30 lbs
Location
Oklahoma, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
1 month ago