Indian Preference in hiring is given to qualified enrolled members of Ketchikan Indian Community (KIC) and Native Americans consistent with P.L. 93-638 and in accordance with KIC policy and other applicable federal laws.

Purpose

Ketchikan Indian Community (KIC) job descriptions are a management tool to help organize duties and provide employees with the employer's expectations with regard to specific job classification. The responsibilities listed are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is a reasonable assignment for the position. This job description is not an employment agreement or contract. Management has the exclusive right to alter this job description at any time without notice.

Job Summary

Incumbent is responsible for providing comprehensive organizational and administrative support to Clinic Administration, while coordinating and completing projects, events, activities, trainings, and the tasks necessary to support the departments strategic plan. Manages the credentialing, re-appointment, privileging, and payer enrollment process for all licensed health care professionals in accordance with the approved credentialing policies and procedures, medical staff by-laws, and rules and regulations of KIC Tribal Health Clinic (THC).

Job Duties and Responsibilities

• Plans, schedules, and coordinates key meetings, conferences, teleconferences, while attending and participating in appropriate clinic administrative and/or committee meetings.
• Coordinates and participates in training initiatives regarding quality and process improvement, involving key staff and stakeholders.
• Ensure project completion by corresponding with employees, stakeholders, administration, and others to facilitate timely completion and quality functioning through term of a project.
• Assist in ongoing implementation tracking and review of clinic projects and plans.
• Acts as a backup to key positions within Clinic Administration, including but not limited to the Quality Improvement Specialist, Patient Advocate, and Clinic Executive Assistant.
• Assists with clinic housing needs, such as check-in and check-out inspections, ensuring apartments are properly turned over, and coordinates any maintenance upkeep.
• Maintains working knowledge and departmental compliance with AAAHC Accreditation, policies and procedures, medical staff by-laws, and other regulatory and accrediting bodies.
• Coordinates the credentialing and reappointment for all licensed health care professionals by verifying provider credentials including education, training, Licensure, board certifications, work history, etc.
• Collaborates and serves as a liaison between providers, management, AHB members, and the ANTHC credentialing team to update and maintain all required documents, while communicating with providers to obtain necessary documentation and information to ensure completeness of credentialing records.
• Monitors and tracks the status of licenses, certifications, and other credentials to ensure timely renewal, while also ensuring providers are in good standing.
• Meets with the Advisory Health Boards Credentialing Committee to bring forward new and reoccurring licensed healthcare professionals requesting credentialing and/or privileging with KICTHC.
• Coordinates and manages the enrollment process for new and existing healthcare providers with multiple insurance companies, including Medicare, Medicaid, and commercial insurance plans.
• Collects, reviews, and verifies all required documentation for provider credentialing, ensu ing compliance with industry standards and regulations.
• Prepares and submits accurate and complete enrollment applications to insurance carriers in a timely manner.
• Monitors the status of submitted applications, follow up with insurance companies, and address any issues or discrepancies to expedite the enrollment process.
• Maintains and updates provider information in internal databases and credentialing software systems.
• Ensures all provider enrollments and credentials are in compliance with state and federal regulations, as well as insurance company requirements.
• Stays informed about changes in insurance enrollment and credentialing requirements and recommend process improvements as needed.
• Other duties as assigned

Minimum Qualifications (Education and Experience)

• High school Diploma or GED
• Minimum three years experience in administrative/secretarial supervisory experience and one year of project coordination or executive assisting required.
• A combination of relevant experience, education, and training may substitute for education and experience requirements on a year-for-year basis.
• Must obtain certification as Certified Professional Medical Services Management (CPMSM), Certified Medical Staff Coordinator (CMSC), and/or a Certified Provider of Credentialing Services (CPCS) within three (3) years of hire.
• Proof of valid driver's license with acceptable driving record.

Preferred Qualifications (Education and Experience)

• Associates degree in healthcare, administration, project management or other related field.
• Certification as a Certified Professional Medical Services Management (CPMSM), Certified Medical Staff Coordinator (CMSC), and/or a Certified Provider of Credentialing Services (CPCS) is preferred but not required.
• Motivation for professional and career advancement.

Necessary Knowledge, Skills, and Abilities

• Strong understanding and sensitivity to American Indian/Alaska Native (AI/AN) Tribal culture and lifestyle, working effectively with AI/AN populations.
• Effective oral and written communication skills with sensitivity to the lifestyles of targeted participants.
• Skills in operating personal computers using a variety of computer software.
• Ability to establish and maintain cooperative working relationships with management, coworkers, and outside contacts.
• Ability to maintain strict confidentiality and comply with all applicable federal and tribal privacy laws and KIC policy (HIPAA, HITECH, etc.).
• Ability to learn and apply program/agency operating policies and procedures.
• Ability to manage multiple priorities and tasks concurrently and meet deadlines.
• Ability to work independently as well as with teams.

KIC Competencies

Cultural Competency: To be respectful and responsive to the health beliefs, practices, and cultural and linguistic needs of KIC Tribal Members. Developing cultural competence is an evolving, dynamic process that takes time and occurs along a continuum.

Commitment: To serve Tribal Members and set a high standard for yourself in your performance; strive for results and success; convey a sense of urgency and bring issues to closure; and stay persistent despite obstacles and opposition.

Customer Service: Meet/exceed the expectations and requirements of internal and external customers; identify, understand, and monitor the needs of both internal and external customers; always talk and act with customers in mind; and recognize working colleagues as customers.

Effective Communication: Ensure important information is passed to th