PURCHASED & REFERRED CARE ADMINISTRATIVE

Come work for Marimn Health - voted one of the Best Places to Work in the Inland Northwest in 2018, 2019, 2020, 2021, 2022 and 2023 and Modern Healthcare's Family Friendliest Employer in 2020! Fantastic benefits, flexible schedules, paid holidays and ability to choose vacation times!

Please note that this position is in Plummer, ID. Carpool opportunities are available.

QUALIFICATIONS: High School diploma or GED required. Coeur d’Alene Tribal cultural competence required.  Driver’s license required.  One (1) year to learn and demonstrate soft skills and oral and written communication. Be willing to gain a certification in Microsoft Office, Excel Spreadsheets, and learn NextGen electronic health records. Telephone communications skills required. Experience with electronic health records and excel spreadsheets preferred. 

ADA ESSENTIAL FUNCTIONS:                                  

• Hearing: within normal limits with or without use of corrective hearing devices;
• Vision: adequate to read 12-point type with or without use of corrective lenses
• Must be able to verbally interact with staff, clients and public
• Manual dexterity of hands/fingers for writing, computer input
• Able to lift up to _30_ lbs.,
• Sitting 50-90% of the day
• Standing/Walking25% of the day
• Pushing, up to 25 lbs.
• Pulling, up to 25 lbs.

RESPONSIBILITIES:

• Answers phones and directs calls to appropriate person or department. Relays messages.
• Manages patient registration and compliance for all Purchased & Referred Care clients.
• Creates PRC identification cards. Tracks yearly registrations due dates through excel spreadsheet. Sends update packets annually.
• Directs and disseminates information to PRC clients.
• Updates and documents client status in the NextGen system.
• Assists with PRC mail and labels for routine mail outs.
• Assures compliance in accordance with PRC program guidelines.
• Scans and files all PRC documents using NextGen document management.
• Manages department inventory and process purchase orders through Work Flow.
• File records. Work closely with records custodian.
• Manages “S” drive file for purchased and referred care program.
• Audits paper files quarterly and present findings.
• Assists in tracking statistical data based on types of referrals, patient demographics, etc. that may impact the PRC program.
• Works closely with Outreach & Enrollment to determine eligibility, insurance coverage, and alternate resources.
• Assists with maintaining updated list of preferred providers that are in network with HMA and works with the PRC Manager to establish and maintain contractual agreements with providers.
• Scrubs daily Marimn Health schedule for PRC clients checking for updated registration and compliance with AR.
• Helps compile CHEF case documentation/files.
• Responsible for utilizing electronic and technical devices that promote NextGen such as document scanning, claims processing, telephone tasking, and other components of NextGen that may be necessary to serve the PRC client and Marimn Health organizational goals.
• Other duties as assigned.