Medical Benefits Coordinator - Sycuan Health Center

POSITION SUMMARY   The Medical Benefits Coordinator (MBC) plays a key role in supporting the front-end operations of the revenue cycle by guiding patients through the complexities of medical insurance and billing. Serving as the primary liaison between patients, providers, and payers, the MBC ensures that insurance benefits are accurately aligned with treatment plans and financial responsibilities. This role also manages billing inquiries, facilitates patient portal engagement, and promotes transparent communication to enhance the overall patient experience. By improving access to information and supporting insurance-related quality metrics, the MBC helps strengthen clinic capacity and drive positive health outcomes.  Job Duties and Responsibilities:  (Note: Duties and responsibilities may be added, deleted or changed at the sole discretion of Sycuan management at any time)  Essential Functions of the Job:  Patient registration and intake:  Collecting accurate demographic and insurance information  Verifying identity and updating electronic health records (EHR)  Ensuring completeness of required forms and consents  Reminding patients of scheduled appointments  Insurance Verification & Eligibility:  Confirming active coverage and benefit details 2 days prior to service through insurance portals or by phone  Identifying primary vs. secondary insurance  Checking for authorization or referral requirements  Financial Counseling Cost Estimates and Collections:  Providing patients with out-of-pocket cost estimates  Explaining deductibles, copays, coinsurance, and coverage limits  Discussing payment plans or financial assistance options  Collecting copays and outstanding account balances   Patient Communication & Education:  Educating patients on their financial responsibilities  Answering billing-related questions before and after services are rendered  Engaging with patients directly, delivering exceptional customer service while demonstrating cultural sensitivity and competency  Assisting patients in overcoming financial and social barriers by facilitating access to interpreters, transportation services, and other support resources  Data Accuracy & Documentation:  Flagging potential billing issues (e.g., duplicate accounts, incorrect or missing info)  Communicating discrepancies with billing teams  Maintaining strict confidentiality in compliance with HIPAA guidelines  Recording and logging of all patient interactions  Team Responsibilities:  Planning and organizing tasks to meet deadlines  multitasking in a fast-paced environment  Meeting with team lead weekly or bi-weekly to discuss development   Supporting teammates during downtime  Seeking professional growth and development through participation in educational programs  Performing other related duties as assigned or requested by Supervisor or Manager  Treating all clients and staff, and the community with respect and courtesy  Participating in Continuous Quality Improvement CQI activities  Essential Qualifications  High school diploma or GED equivalent  Valid California driver’s license or reliable transportation  Minimum 6 months experience in a medical reception or healthcare setting  Strong understanding of health plans and insurance coverage  Familiarity with insurance portals and Electronic Health Record (EHR) systems  Basic computer skills    Familiarity with patient financial account management  Team-oriented with a collaborative mindset    Desirable Qualifications  3+ years experience in a medical or healthcare setting  Bi-Lingual (Spanish preferred)  Experience with NextGen EHR system  Background in medical billing  Prior experience working in a Tribal clinic environment    Other Essentials:  Ability to speak, read and write in English  Ability to sit or stand for prolonged periods of time  Ability to lift up to 40lbs  Ability to perform repetitive bending, reaching, pulling and pushing movements  Ability to use various office machines  Ability to communicate and interact effectively with patients and staff  Ability to understand and follow oral and written instructions  Ability to maintain confidentiality  Ability to maintain a professional appearance and demeanor  Ability to adhere to SMDC work attendance and punctuality policies  Ability to accept constructive criticism