Member Services Enrollment Coordinator

Under the supervision of the Member Services Manager, the Member Services Enrollment Coordinator works with patients and community members to provide education and assistance related to enrollment in Medicaid, Children’s Health Insurance Program (CHIP), and the Health Insurance Marketplace. The coordinator supports enrollment and eligibility across all health programs, maintains high data entry standards, and serves as a backup for processing authorizations for qualifying members.

Strict privacy policies protecting patient and client information are adhered to.

Monday – Friday: 8:00 AM – 5:00 PM
1‑hour lunch break (unpaid)

• Provides information to Health Staff regarding the coordination, education, and assistance of individuals enrolling in Medicaid, CHIP, Health Insurance Exchange, Food Stamps, and Child Care.
• Travels within the service area to meet clients one‑on‑one and acts as a liaison between the individual and the state when necessary.
• Contacts patients within three days of a referral who lack coverage or are not eligible for Purchased Referred Care (PRC); follows up on pending cases and documents incomplete applications.
• Works closely with clients, the PITU PRC program, and the state “MyCase” program to ensure ongoing eligibility, including annual Medicaid review.
• Acts as an advocate for Tribal Members.
• Coordinates with department managers and patient care to ensure consistent communication.
• Provides training to Clinic Receptionists and other support staff on data entry into the Electronic Health Record, including updating eligibility and insurance information.
• Performs weekly audits of PRC health center appointments to ensure accurate capture of registration, eligibility, and insurance information.
• Keeps supervisor informed of work progress through weekly reports, including statistics and innovative suggestions.
• Reviews reports for patients under 18 and over 65 quarterly; contacts all patients/guardians to enroll them in alternate resources.
• Reviews, approves, or denies sliding fee applications and ensures proper documentation is uploaded to the EHR.
• Attends meetings, conferences, workshops, and training sessions to stay current on developments affecting patient benefits.
• Responds to requests and questions in a courteous and timely manner.
• Verifies the mailing address of Tribal Members annually and updates the system if information changes.
• Reminds Tribal Members to apply for alternate resources within policy‑allowed time frames and reports when applications are incomplete.
• Provides backup support for receptionists and authorization processing as needed.
• Performs other duties assigned to support efficient operations of the Tribe.

• Knowledge of Medicaid, CHIP, and Medicare programs.
• Exceptional flexibility and positive interpersonal skills.
• Willingness to learn new tools and technologies.
• Maintains a positive attitude and works well under tight deadlines.
• Establishes and maintains effective relationships at all organizational levels and within the community.
• Demonstrates respect for and awareness of Native American customs, traditions, and socioeconomic needs.
• Excellent oral and written communication skills, including public speaking across diverse audiences.
• Willingness to travel weekly.
• Knowledge of health insurance terms and enrollment processes.

• Must be insurable through the Tribe’s vehicle insurance plan.
• Must pass a criminal and fingerprint background check per P.L. 101‑630 standards.
• Must pass a pre‑employment alcohol/drug screening.

• High School diploma, GED, or higher required.
• One year of experience in a health‑related field required.
• Preferred: one year of experience with insurance enrollment (Medicaid, CHIP, Marketplace).

• Must possess, maintain, and provide proof of a valid driver’s license.
• Must obtain, maintain, and provide proof of a valid Certified Application Counselor Training certification within one month of hire.

• Group Health Care Plan (Health, Dental, Vision, Life/AD&D, and Long‑Term Disability); employer‑paid premiums for employee, spouse, and dependents.
• Supplemental/Voluntary Benefits (Life/AD&D, Short‑Term Disability, Hospital Indemnity, Accident, Critical Illness).
• HSA Bank Account – monthly employer contributions.
• Retirement Plan (401(k), Roth) – dollar‑for‑dollar match up to 6%.
• Paid Time Off (PTO).
• Paid Holidays (Federal, State, and Tribal) – paid according to the set work schedule.
• Paid Birthday Leave.
• Paid Bereavement Leave.
• Employee Assistance Program.
• Education Assistance Program.
• Wellness Program – earn up to $1,000 into your HSA account per year.

• Seniority level:
  Entry level
• Employment type:
  
  Full‑time
• Job function:
  Other
• Industry: Government Administration