PRC Technician

Ketchikan Indian Community • Ketchikan, AK

3d • $21 - $32 • Onsite

About The Position

Incumbent will provide purchasing, accounting, and clerical functions needed in support of the Purchase & Referred Care (PRC) services program. Cross train with other team members as backup and perform other duties as assigned.

Requirements

• Knowledge of the Health Insurance Portability and Accountability Act (HIPAA)
• Skill to operate software programs
• Ability to obtain personal information (demographics, employment, insurance information) from clients in a respectful and skilled manner.
• Ability to communicate professionally over the telephone and in person in a positive and clear manner
• Ability to manage multiple tasks, including telephone, computer operations and in-person visits simultaneously
• Ability to take verbal instruction and complete assigned project by established deadline
• Ability to be flexible in order to perform at the highest level as a team player
• Ability to utilize maximum degree of professionalism and diplomacy with those who may be experiencing a high degree of stress both mentally and/or physically (both patients and co-workers)
• Ability to work independently with minimal supervision and able to prioritize assignments
• Ability to maintain confidentiality of all KIC operations and staff.
• Must be able to work in an office environment in a stationary position the majority of the workday.
• This position needs to occasionally move about inside the office environment to access office equipment, attend face-to-face meetings on / off site as needed, zoom meetings, teleconference calls, videoconferencing, e-mail, and similar activities, etc.
• Routinely lifting and carrying items and boxes up to ten (10) pounds.
• Large portion of time will be spent in front of computer screen, researching and reviewing various documents for final disposition to internal / external customers.
• Writing by hand and using a personal computer.
• Traveling occasionally, to out-of-town meetings and functions.
• Possess current valid State of Alaska driver's license with a record acceptable to KIC’s Insurance carrier.
• High school diploma or equivalent required.
• Progressive responsible clerical, office or other work that indicates ability to acquire the particular knowledge and skills needed to perform duties of this position.
• Minimum one-year general office experience.

Nice To Haves

• medical terminology training
• knowledge of Contract Health Service rules and regulations

Responsibilities

• Issue on-line PRC authorization forms daily for payment to contract and non-contract providers for health care services provided to eligible tribal member patients.
• Determines appropriate coding/accounting data.
• Tracks and verifies patient referrals for proper eligibility and documentation.
• Screens all requests for payment of medical/dental care services for other resources such as Medicare, Medicaid, private insurance, Veteran’s Administrations, Industrial Accident, BEC, etc.
• Initiates follow up with fiscal pending claims, delayed payments, and other pertinent documents/information.
• Sends letters to patients and health care providers regarding bills and scope of services available.
• Maintains correspondence regarding PRC program, includes copies of denial letters to providers, etc.
• Assure all outstanding authorizations over ninety (9)0 days old are valid; others are canceled and funds are re-obligated before the end of the fiscal year.
• Share on-call Patient Travel responsibilities as scheduled.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED