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Patient Benefits/PRC Coordinator

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Job Description - Patient Benefits/PRC Coordinator


KAW NATION POSITION DESCRIPTION


 TITLE:                                                          Patient Benefits / PRC Coordinator

 IMMEDIATE SUPERVISOR:                   PRC/Benefits Supervisor/Health Director

 CONTROLLING SUPERVISOR:            Chair

 STATUS:                                                       Full Time

LOCATION:                                                 Kanza Health Clinic, Newkirk



QUALIFICATIONS: 

Minimum of one (1) year experience in a clinical environment and related field.  Ability to relate and interact with patients assisting them in programs that are available to Native Americans.  Possess interpersonal skills in reading, writing and speaking which would include good communication skills.  Must be able to multi task and work with minimum supervision. Prefer candidate to have some third party billing experience and knowledge of RPMS(Resource Patient Management System).  Must have proficient computer skills. Must have a valid driver’s license.

RESPONSIBILITES AND DUTIES:

1. Identifies patients who are eligible for alternate resources such as Children’s Health Insurance Program Reauthorization Act (CHIPRA), Medicare, Medicaid, Sooner Care, Indian Health Service Programs, Affordable Care Act/Health Exchange plans and private health insurance programs and any other alternate resources that might be available. 
  • Determining if the patient qualifies for alternate resources,
  • Assisting the patient with completion of the application, and
  • Computer documentation of results.

2.  Enhance patient care through increased revenue from other insurers.
3.  Maintain information for use in reports requested by supervisor.
4.  Advocate on behalf of patients with all alternate resources
5. Effectively, educate patients on alternate resources and enrolling them in programs that will benefit them as well as enable the clinic to offer more services.
6.  Work closely with Patient Registration and Purchased Referred Care in screening potential patients who are eligible for alternate resources.
7.  Abide by the HIPAA Privacy Act of 1974 to maintain confidentiality of all records.
8.  Awareness of Social Service programs offered to Kaw tribal members.
9. Complete daily referrals in coordination with PRC supervisor.
10. Knowledge of medical terminology, ICD and CPT codes.
11. Requesting and scanning medical records form outside providers.
12. Complete any other duties assigned by immediate/controlling supervisor.


All new hires will be required by the Kaw Nation to submit to a pre-employment drug screen.  Failure to pass the pre hire drug screen will lead to withdrawal of the job offer or termination of employment. All new hires must be able to stand, walk, stoop, bend, kneel, pull, push and lift a minimum of 25 lbs. 
 
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