PRC Assistant

Mohican Nation•Bowler, WI

2d•Onsite

About The Position

This position oversees the functions of the PRC Department in the absence of the PRC Manager. The PRC Assistant is responsible for obtaining detailed client information to determine eligibility for the Stockbridge-Munsee PRC Program, responding to inquiries from clients and outside health services providers, and authorizing referrals for payment determination. The role involves maintaining a record-keeping system for program eligibility data, staying knowledgeable about alternate resources, and using the EHR system for patient information, voucher processing, and report generation. Additionally, the position handles correspondence with providers and patients, prepares reports, and processes client vouchers and bills for payment or denial. The PRC Assistant must maintain an acceptable departmental attendance record, be reliable and prompt, and attend job-related training to maintain knowledge. Adherence to tribal law, personnel policies, and potential proficiency testing is also required. Duties are subject to change based on organizational needs and supervisor direction.

Requirements

Must be at least 18 years old with a High School Diploma or GED.
High organizational skills required.
Six months experience with Microsoft Office Suites such as Word, Excel, and Outlook is required.
One year data entry experience is required.
Must be able to work within an environment of strict confidentiality and adhere to strict policy pertaining to confidential matters.
Ability to work with a minimum of supervision.
Understand rules and regulations of Medicare, Medicaid, third party insurance, and other state health insurance programs, etc.
Must be willing to attend all applicable training.
Must pass pre-employment drug and health screening.
Must adhere to the Tribe’s Drug and Alcohol-Free Workplace Policy during the course of employment.
Must be eligible for coverage under the employer’s liability insurance.
Must have demonstrated ability to maintain satisfactory working record in any prior or current employment.
Must submit and pass a background security check to meet the Elder/Youth License Requirement as it pertains to the position and the location of the department prior to and during the course of employment with the Stockbridge-Munsee Community.
Must be able to meet physical requirements of position.
Must abide by departmental and organizational safety, testing, and uniform guidelines.
Must submit to and pass a pre-employment drug and health screening.
Must maintain an acceptable departmental attendance record.
Must be able to work weekends, nights and holidays.
Must obtain and maintain Elder/Youth License as stated on job description.

Nice To Haves

Experience with Access database, PowerPoint for minimum of six months is preferred.
Knowledge of the Indian Health Service Contract Health Program preferred but not required.
Knowledge of other fiscal resources that clients may be eligible for preferred but not required.
Knowledge of office machines and computer helpful.

Responsibilities

Oversee the functions of PRC Department in absence of PRC Manager.
Obtain detailed client information to determine client’s eligibility for the Stockbridge-Munsee PRC Program.
Respond to all inquiries from clients and outside health services provider(s) concerning program eligibility, billing, and other related issues.
Responsible for authorizing referrals for determination of payments.
Maintain a record keeping system of data for eligibility of PRC Program.
Maintain working knowledge of alternate resources available and refer clients for assistance.
Use the EHR system for maintaining patient information, process vouchers, and other required reports/forms for the PRC program.
Reply and maintain correspondences with providers and patients using letters, email, fax etc.
Prepare reports as directed.
Prepare client vouchers and bills for payment or denial.
Must maintain an acceptable departmental attendance record.
Must be reliable and prompt when reporting to work.
Required to attend job related, in-service, meetings, and training to maintain professional and technical knowledge.
Must adhere to tribal law and other applicable laws as well as tribal personnel policies and procedures.
May be required to satisfactorily complete an exam or other testing requirement(s) to determine skill proficiency.