Purchased/Referred Care (PRC) Receptionist (TM46201)

Position: Purchased-Referred Care (PRC) Receptionist

Department/Site: Colville Tribe Healthcare Authority - Nespelem

Reports to/Evaluated by: Purchased/Referred Care (PRC) Administrator

FLSA: Non-Exempt

Salary Grade: 116

SUMMARY:

Facilitates medical care for patients by scheduling appointments, and managing documentation to ensure compliance with federal or tribal guidelines. Administers all daily activities of the Purchased and Referred Care (PRC) Program and provides clerical assistance and support to the PRC team. Serves as a facilitator between patients and providers of the CTHCA Health team by scheduling appointments for referrals as needed, requesting records. Serves as an advocate for PRC eligible patients to resolve medical bills in collections.

ESSENTIAL FUNCTIONS:

• Knowledge of rules and regulations pertaining to the CCT Purchased and Referred Care Program so as to assure referrals and assistance with obtaining services can be implemented.
• Administer all daily activities of the PRC Program:
  • Manages PRC patient files and compliance for all PRC patients
  • Request documents from providers as needed - Enters patient data into the appropriate databases; maintains accurate files, and organizes data.
  • Answer telephone calls from patients-vendors with a positive, helpful, customer service attitude.
  • Responds to PRC inquiries and requests for PRC assistance.
  • Performs routine clerical office duties o Maintains the strictest confidentiality; adheres to all HIPAA guidelines/regulations.
  • Understand and adhere to approved PRC Policy and Procedure Manual.
• Process, track, and provide follow up communication to patients regarding health bills paid on their behalf.
• Assist with billing problems, appointments, and referrals assuring all issues are completed and followed up on in a timely manner.
• Coordinate PRC Committee monthly meetings; preparing all information and follow up with patients and providers a necessary per PRC policy and procedures.
• Assist with annual PRC audit
• Audit PRC files quarterly and presents findings to Revenue Cycle Director
• Obtain pricing documentation and other necessary documentation as needed.
• Assist patients with documentation of the 72-hour emergency room requirement
• Attends meetings and approved trainings as necessary.
• Directs and disseminates information to PRC patients
• Assists with PRC mail and labels for routine mail outs
• Assist other PRC staff with claims as needed to minimize backlog
• Post office and mail pick up
• Effectively plan, organize workload and schedule time to meet the demands of the position
• Utilize effective verbal and written communication skills
• The Tribe values its commitment to community service and the well-being of its members. In recognition of this, each employee may be expected to perform duties from time to time which may not be related to their regular responsibilities
• Other duties as assigned

KNOWLEDGE, SKILLS, AND ABILITIES:

• High School graduate or equivalent.
• Experience (3+ years) in administrative role in a medical or business setting
• Valid WA State Drivers License
• Experience with electronic health record software, preferred
• Possess the ability to interact with a wide variety of individuals and handle complex situations
• Requires impeccable communication and negotiation skills, written, and verbal, and excellent computer skills.
• Culturally sensitive to Native Americans
• Self-motivated
• Must be able to prioritize work tasks
• Knowledge of administrative office procedures and systems such as work processing, managing files and records, designing forms, and workplace terminology.
• Excellent computer and phone skills with great customer service attitude.
• Must have excellent organization, verbal, and interpersonal skills
• Excellent service approach when dealing with patients
• Requires excellent communication skills both written and verbal
• Confident in making phone calls to outside health offices
• General office principles as practices, computer software applications relative to the position assignment, basic accounting, conflict resolution techniques, operation of standard office equipment that may include personal computer, copier, fax machines and multi-line telephone, program specific information, terminology and-or equipment.
• Must be able to follow oral and written instructions, working independently, prioritizing confidentiality on sensitive matters.

PHYSICAL REQUIREMENTS:

• Ability to sit and stand for long periods of time
• Manual and finger dexterity to complete duties
• Ability to frequently bend, stoop, and reach
• Ability to push and pull frequently
• Ability to comprehend complex issues
• Sufficient visual acuity to write, recognize printed materials, computer screen, and notice nonverbal behavior
• Speech and hearing ability to project voice to small and large audiences, carry on telephone conversations, hear and grasp verbal communications and equipment prompts
• Ability to drive in adverse weather conditions

Note: Pursuant to Tribal Policy, if this position is safety sensitive it is subject to pre-employment drug testing. In addition, this position is subject to reasonable suspicion and post-accident drug testing.

TRIBAL MEMBER AND INDIAN PREFERENCE WILL APPLY; PREFERENCE WILL ALSO BE GIVEN TO HONORABLY DISCHARGED VETERANS WHO ARE MINIMALLY QUALIFIED.

If required of this position, you must possess and maintain a valid Washington State driver’s license and be eligible for the Tribes’ Vehicle Insurance. In addition, this position may be subject to pre-employment background clearances. If applicable, these clearances must be maintained throughout employment.

INFORMATION: Terri Mail, HR Generalist, Colville Tribal Health Care Authority, Human Resources Office, P.O. Box 150, Nespelem, WA 99155, (509) 846.3774. terri.mail.ohc@colvilletribes.com