Tribal Benefits Manager (37106)

Come work for the leading employer in the Coachella Valley. Agua Caliente offers a comprehensive benefit and compensation package that includes rich medical and dental benefits, a 401k plan with employer match, more than 3 weeks of paid time off per year for newly hired employees, and other great benefits like food and beverage discounts at our three casinos, fuel discounts, tuition and wellness reimbursement, plus much, more.

JOB DESCRIPTION SUMMARY

The Tribal Benefits Manager provides dedicated administrative and advocacy support to ensure Tribal Members fully understand and utilize their health and group benefits. This specialized role focuses entirely on serving the unique health and benefit needs of Tribal Membership.

ESSENTIAL DUTIES AND RESPONSIBILITIES (other duties may be assigned)

• Guide Tribal Members through the complete enrollment process for health and group benefits programs.
• Manage all aspects of record-keeping, auditing, and compliance associated with membership benefit plans.
• Communicate directly with insurance providers, carrier representatives, and third-party administrators to ensure accurate updates, changes, and record management.
• Act as the primary, accessible point of contact to answer questions regarding plan coverage, co-pays, and provider networks.
• Assist members in navigating, investigating, and resolving complex medical, dental, or vision claim disputes and billing errors.
• Review, verify, and submit member Flexible Spending Account (FSA) and other claim reimbursement documentation.
• Process specialized Tribal Membership benefit requests, including caregiver payments and durable medical equipment (DME) requests.
• Collect, organize, and track specific data pipelines to support medical claim review and the Tribal MLR program.
• Create and publish membership communications, including flyers and memoranda.
• Protect member privacy by handling all Protected Health Information (PHI) and personal documentation with strict confidentiality and HIPAA compliance.
• Deliver all services with deep respect for Tribal traditions, community dynamics, and cultural values

SUPERVISORY RESPONSIBILITIES

None

ACCESS TO SENSITIVE AREAS AND INFORMATION

Full access to highly confidential materials, including Protected Health Information (PHI) and Tribal Member personally identifiable information (PII).

SIGNATORY ABILITY

Authorized to sign benefit-related forms and documents.