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 department’s 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 & 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 Board’s Credentialing Committee to bring forward new and reoccurring licensed healthcare professional’s 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, ensuring 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 & 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 & 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, & 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 those who need to know; convey necessary information with respect, clearly and effectively orally or in writing.
• Responsiveness and Accountability: Demonstrate a high level of conscientiousness; hold oneself personally responsible for one's own work; and do the required fair share of work.

Working Conditions

The physical demands described here are representative of those that an employee must meet to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform these functions.  

While performing the duties of this Job, the employee is regularly required to use hands to finger, handle, or feel; reach with hands and arms; and talk or hear.  The employee is frequently required to stand and/or sit. The employee is occasionally required to walk, sit, climb, or balance. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds.  Specific vision abilities required by this job include close vision, peripheral vision, and depth perception.  The noise level in the work environment is usually average.

Conditions of Hire

• May be required to possess and maintain a valid driver's license or capable of obtaining one, as well as be insurable by KIC's company insurance. 
• KIC is a Drug-Free Workplace. All employees must adhere to KIC drug and alcohol policies and procedures to ensure a safe workplace. Employees must pass a pre-employment and subsequent random and/or for cause drug and alcohol screening to be eligible for and maintain employment. 
• KIC has several positions that must comply with P.L. 101-630 Indian Child Protection and Family Violence Protection Act (ICPA); all employment offers in the "covered" classification are conditional until KIC has received a Federal Criminal Background Check verifying eligibility to work in these programs. 

This job description describes the essential duties and qualifications. It is not an exhaustive statement of all the job duties, responsibilities, or qualifications; management has the exclusive right to alter or add to this job description at any time without notice. Incumbent(s) may not be required to perform all duties listed and may be required to perform additional duties as assigned.