About this role
Verifies claims eligibility, reviews claims for accuracy and appropriateness of billing, coordinates third party benefits, prepares check requests, picks up and disburse checks, maintains records, tracks and prepares high cost cases for IHS reimbursement. Other duties as assigned.
Qualifications
EDUCATION REQUIREMENT
High school diploma or general education degree (GED).
EXPERIENCE REQUIREMENT
At least two years experience in a related field.
COMPUTER SKILLS
An individual should have knowledge of Accounting software; Database software; Internet software; Spreadsheet software and Word Processing software.
CERTIFICATES, LICENSES, REGISTRATIONS
Must possess a valid driver's license with a driving history verified through a motor vehicle report that meets the requirements for Cherokee Nation underwriting. Driving is necessary to attend trainings, pick up and disburse checks.
OTHER SKILLS AND ABILITIES
None
OTHER QUALIFICATIONS
Employee must not and will not be under sanction by the United States Department of Health and Human Services Office of the Inspector General (OIG) or by the General Services Administration (GSA) or listed on the OIG’s Cumulative Sanction Report, or the GSA’s List of Excluded Providers, or listed on the OIG’s List of Excluded Individuals/Entities (LEIE).
PHYSICAL DEMANDS
While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is frequently required to reach with hands and arms. The employee is occasionally required to stand; walk; climb or balance and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 10 pounds.
WORK ENVIRONMENT
The noise level in the work environment is usually moderate.
Other facts
About Cherokee Nation
The Cherokee Nation is a sovereign tribal government, the largest in the United States with more than 450,000 tribal citizens around the world. Working at the Cherokee Nation means working in the spirit of gadugi – it’s how we say working together. As a work family, we’re committed to protecting our inherent sovereignty; preserving and promoting Cherokee culture, language and values; and improving the quality of life for the next seven generations of Cherokee Nation citizens.
With 11,000+ employees, Cherokee Nation and its subsidiaries are among the largest employers in northeastern Oklahoma. We’re always looking for the next healthcare heroes, classroom leaders, Cherokee language warriors, social services champions, retail experts, law enforcement protectors, construction connoisseurs and so much more.
Explore career opportunities with our tribe at cherokeenationjobs.org and follow our page to learn more about the employees who serve the Cherokee people.
What you'll do
- The Health Claims Auditor I Non-Certified verifies claims eligibility and reviews claims for accuracy and appropriateness of billing. Additional responsibilities include coordinating third party benefits and maintaining records.
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