PRC Technician

KETCHIKAN INDIAN CORPORATION • Ketchikan, AK

8d • $21 - $32 • Onsite

About The Position

Ketchikan Indian Community (KIC) job descriptions are a management tool to help organize duties and provide employees with the employer’s expectations with regard to a specific job classification. The duties listed are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is a reasonable assignment for the position. This job description is not an employment agreement or contract. Management has the exclusive right to alter this job description at any time without notice.
Job Summary
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 work day.
• 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

• Prefer individual with 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