General Clerk II

Koniag Government Services, LLC•Poplar, MT

4d•Onsite

About The Position

Koniag Advisory Business Solutions, LLC, a Koniag Government Services company, is seeking a General Clerk II to support KABS and our government customer at Poplar, MT. This position requires the candidate to be able to obtain a Public Trust. This position is covered under the Service Contract Act. We offer competitive compensation and an extraordinary benefits package including health, dental and vision insurance, 401K with company matching, paid holidays, paid Vacation, paid sick leave and more. We are seeking an experienced General Clerk II to provide advanced administrative support for the Purchased Referred Care (PRC) program within the Billings Area Indian Health Service (BAIHS). This position requires specialized knowledge of PRC eligibility requirements and systems and plays a critical role in ensuring patients receive appropriate healthcare coverage and authorization.

Requirements

Meet minimum qualification requirements as outlined in prime contract
Advanced knowledge of PRC program regulations, eligibility criteria, and procedures
Strong analytical and problem-solving skills
Excellent verbal and written communication skills
Proficiency in PRC computer systems and database management
Ability to interpret and apply complex program guidelines
Strong attention to detail and accuracy in financial transactions
Successful completion of background check
Compliance with all IHS policies and procedures
Adherence to HIPAA privacy and security requirements
Participation in site-specific orientation and competency assessments
Computer security training and compliance
Ability to handle sensitive financial and medical information
Position may involve coverage at multiple BAIHS locations
Must be flexible to support continuous service delivery
May be required to assist with emergency authorizations outside normal business hours
Ability to obtain a Public Trust

Nice To Haves

Previous experience with Indian Health Service or tribal healthcare systems
Knowledge of federal healthcare programs and regulations
Experience with contract health services or similar programs
Background in healthcare administration or patient services

Responsibilities

Assist in determining patient eligibility, scope of benefits, and priority levels for the PRC program
Review and analyze patient applications and supporting documentation
Apply PRC program guidelines and regulations to make eligibility determinations
Ensure compliance with federal Indian Health Service policies and procedures Customer Service & Communications
Respond to complex PRC inquiries and requests via telephone, written correspondence, and in-person consultations
Provide detailed explanations of PRC benefits, limitations, and procedures to patients and families
Serve as a resource for PRC program information and guidance
Maintain professional communication with healthcare providers, patients, and families
Maintain comprehensive follow-up systems for Contract Health Services (CHS) patient files
Track patient cases from initial application through completion of services
Ensure timely processing of referrals and authorizations
Monitor case progress and coordinate necessary follow-up actions
Ensure proper allocation of funds for patient referrals, emergency call-ins, and follow-up care
Monitor budget constraints and funding availability for PRC services
Enter and verify authorizations, payments, cancellations, and supplements in PRC computer systems
Maintain accurate financial records and documentation
Process payment authorizations and modifications as required
Utilize PRC information systems for data entry, retrieval, and reporting
Maintain accurate and up-to-date patient records in electronic systems
Generate reports and track program metrics as needed
Ensure data integrity and security compliance