Any individual who receives an offer of employment or will receive a payroll check are required to submit to a drug and alcohol test as a condition of obtaining employment.
Mille Lacs Band Member/American Indian preference applies

SUMMARY:
Circle of Health was developed to assist with premiums, co-pays and deductibles for the Mille Lacs Band of Ojibwe Band members and their prospective families. The Intake Specialist will conduct a one-on-one intake session that begins a relationship of trust and purpose between the Circle of Health and the participant. The Intake Specialist will collect pertinent information, review and approve enrollment forms in accordance with Circle of Health standards and guidelines. The Intake Specialist will work closely with Claims Processors and Benefits Coordinators to ensure they have complete information for Circle of Health program eligibility.

QUALIFICATIONS:
• Two years post-secondary education is required.
• Three years of experience of health insurance billing, claims processing, or health insurance enrollment or in human resources benefits.
• Excellent interpersonal and organizational skills.
• Proficiency in Microsoft office programs required.
• Minimum of three years prior experience working in the Native American community and/or working with a diverse group of people.
• Minimum of three years prior experience in case management with demonstrated ability to read, interpret and implement federal, state and tribal laws, regulations and policies as needed.
• Knowledge of Medicare, Medicaid, and private insurance eligibility requirements.
• Basic computing skills in a Windows environment, including Word and spreadsheet software.
• Ability to work and communicate sensitively, confidentially, and effectively with Band members, families, public agencies and co-workers.
• Very strong written and verbal communication skills.
• Knowledge of Data Privacy Act and ability to maintain strict confidentiality of Band member, provider, and Band information.
• Experience in and sensitivity to Native American culture.
• Ability to understand and follow directions.
• Must pass a background check.
• Must pass a pre-employment drug and alcohol test.

DUTIES AND RESPONSIBILITIES:
The initial enrollment intake will cover previous enrollment data needed, identify new data required to complete enrollment, and assisting with acquiring needed documents to complete enrollment file. Circle of Health recognizes that challenges and barriers must be addressed before a person or family can obtain and retain health insurance coverage. The Intake Specialist will assist in all aspects of obtaining needed information to complete a Circle of Health enrollment form.

• Intake Specialist is responsible for processing all Circle of Health enrollment forms.
• Intake Specialist is responsible for approving eligibility, placing accounts on hold and removing hold status’ once a person fulfills their responsibilities for eligibility.
• Processes enrollment forms within one week of receipt of enrollment forms.
• Processes denial of claims within one week from receipt of denied claims.
• Follows HIPAA, data privacy, ISSA, IT Security policies and regulations.
• Ensures that band members are using the correct and chronological avenues in acquiring insurance coverage, then refers person(s) to the Benefit Coordinator for health insurance enrollment.
• Assists Band members with Medicare, Medicaid and other services.
• Assists with Office & File support when needed.
• Assists with Band mailings.
• Creates denial letters and maintains correspondence on the ACT system.
• Maintains monthly log of enrollments and denials, to present to Director and Board of Directors.
• In the absence of another Claims Processor/Benefit Coordinator will assist with band member inquiries to the best of their ability.
• In the absence of another Claims Processor/Benefit Coordinator will process reimbursement claims or enroll people for health insurance.
• Performs other duties as deemed appropriate by Circle of Health Director.

WORKING CONDITIONS:
• Nature of work is such that incumbent experiences infrequent periods of moderate stress levels while dealing with band members, families, and others.
• Work is exclusively in doors in a controlled climate area.
• Little threat of personal danger or risk.
• Hours are typically 8-5, but possibly with some extra hours. May involve some evening or weekend work.