Medical Assistant - PRC - Clinton - IHS

MCSG Technologies • Clinton, OK

5d

About The Position

JOB SUMMARY: Provide Medical Assistant services for the PRC Department at the Clinton Indian Health Center as described under responsibilities below. Contractor shall provide other duties as assigned within the Clinton Service Unit. PRIMARY DUTIES: Responsible for verifying patient eligibility in receiving routine Medical Referrals and/or emergency call-ins for treatment rendered by reviewing documentation in the patient registration regarding eligibility and alternate resources availability for services rendered. Incumbent maintains and utilizes the Resource Patient Management System (RPMS}, Electronic Health Record (EHR} and the Referred Care Information System (RCIS) in reviewing documentation. Responsible for coordination of and provision of patient education regarding the PRC program and associated requirements for eligibility. Interviews and evaluates patients for possible eligibility of an alternate resource, i.e. Medicare, Medicaid, Veteran's Administration, and other private insurance carriers. Ensures patients are referred to the Patient Benefit Coordinator for further assistance. Responsible for interpretation of medical bills and explanation of benefits received from patients and medical providers. Reviews all incoming correspondence from providers. Assist in processes all authorizations and provides information to the Fiscal Intermediary, Blue Cross Blue Shield of New Mexico, regarding authorization of payment. Responsible for determining if an authorization has been issued or has been paid. Responsible for collecting accurate health insurance information from patients to ensure IHS is payer of last resort. Assists in scheduling of patient appointment for PRC referred care and ensures proper follow up with the vendor to ensure patient's care is coordinated in a seamless fashion. Assist in patient inquires, both in person and via phone, and ensures each inquiry is answered in a timely and customer service friendly approach. Ensures patients are informed on the priorities for services based on policy and procedure of the Clinton Indian Hospital IHS PRC program. Greets patients for services at the department window, issues the patient forms to such patients and assists them in the completion of the forms. Answers incoming department phone calls, responding to voicemail messages left by staff and patients for the departments, and calling out to staff and patients as needed for the purposes of relaying pertinent information for patient care coordination. Other duties as assigned.

Requirements

• Background check required.
• SECURITY CLEARANCE: Public Trust

Responsibilities

• verifying patient eligibility
• maintains and utilizes the Resource Patient Management System (RPMS}, Electronic Health Record (EHR} and the Referred Care Information System (RCIS) in reviewing documentation
• coordination of and provision of patient education regarding the PRC program and associated requirements for eligibility
• evaluates patients for possible eligibility of an alternate resource
• interpretation of medical bills and explanation of benefits received from patients and medical providers
• Reviews all incoming correspondence from providers
• processes all authorizations and provides information to the Fiscal Intermediary, Blue Cross Blue Shield of New Mexico, regarding authorization of payment
• determining if an authorization has been issued or has been paid
• collecting accurate health insurance information from patients to ensure IHS is payer of last resort
• scheduling of patient appointment for PRC referred care and ensures proper follow up with the vendor to ensure patient's care is coordinated in a seamless fashion
• Assist in patient inquires, both in person and via phone, and ensures each inquiry is answered in a timely and customer service friendly approach
• Greets patients for services at the department window, issues the patient forms to such patients and assists them in the completion of the forms
• Answers incoming department phone calls, responding to voicemail messages left by staff and patients for the departments, and calling out to staff and patients as needed for the purposes of relaying pertinent information for patient care coordination
• Other duties as assigned

Benefits

• Medical, dental, vision, life insurance, short-term disability, long-term disability, 401(k) match, flexible spending accounts, EAP, parental leave, paid time off, holidays and more.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed