Billing, Calendar Management, Casinos, Co-Payments, Communication Skills, Computer Skills, Cost Estimates, Customer Support/Service, Demographics, Driver's License, English Language, Financial Management, Government, HIPAA (Health Insurance Portability and Accountability Act), Health Insurance, Health Plan, Healthcare, High School Diploma, Insurance, Lift/Move 40 Pounds, Medical Billing, Medical Office Administration, Medical Record System, Medicine, Multilingual, Multitasking, Office Equipment, Organizational Skills, Patient Education, Quality Management, Quality Metrics, Sales Management, Spanish Language, Team Lead/Manager, Team Player, Time Management, Treatment Plan, User Interface/Experience (UI/UX)
The ancestors of the Sycuan Band of the Kumeyaay Nation existed many centuries ago as a community of people…a Tribe living together, farming, hunting and fishing to survive.
Much has changed since that time. Today the Sycuan Tribe governs its Reservation, owns and operates a Casino and a Golf Resort, and owns a number of other business ventures in the San Diego Region.
One attribute that remains unchanged, however, is Sycuans sense of community. Sycuan is more than just a business. Sycuan is a community of people working together toward a common goal. Whether you work in our state-of-the-art Casino, our beautiful Resort, or become a staff member in our Tribal Government division, you will be part of the Sycuan family.
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
If you enjoy being part of a community dedicated to creating a memorable guest experience, we invite you to explore career opportunities with Sycuan and join our winning team!