Patient Benefits Coordinator

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.

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

20. 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