SD – Purchased Referred Care (PRC) Claims Technician – Great Plains Tribal Leaders’ Health Board

JOB TITLE:

Purchased Referred Care (PRC) Claims Technician

DEPARTMENT:

Oyate Health Care

SUPERVISOR:

Supervisor

SALARY:

$19.94 – $30.37

JOB SUMMARY:

  • Answers telephone and greets visitors; provides information and assistance; and resolves problems.
  • Gathers patient demographic information, updates patient information, and determines eligibility for services; and obtains documentation of Indian blood or other documentation of Tribal membership and proof of residency, when necessary.
  • Maintains, key-enters, updates, and verifies all Alternate Resources data necessary for patient registration and for accurate billing, and makes corrections as necessary to improve the Purchased Referred Care process.
  • Reviews UB-04 and CMS 1500 claim forms for accuracy and completeness.
  • Re-prices all clean claims utilizing appropriate software. Communicates claims outcomes to vendors and patients.
  • Works with finance staff to ensure claims are paid in a timely manner.
  • Maintain effective communication techniques between PRC and outside vendors.
  • Save all repriced claims; be familiar with shared file methods and how to store, manage and share files.

JOB RESPONSIBILITIES:

  • Answers telephone and greets visitors; provides information and assistance; and resolves problems.
  • Gathers patient demographic information, updates patient information, and determines eligibility for services; and obtains documentation of Indian blood or other documentation of Tribal membership and proof of residency, when necessary.

MINIMUM REQUIREMENTS:

  • Associate degree and one (1) year of relevant administrative office support; or a high school diploma or equivalent and three (3) years of relevant administrative office support experience sufficient to understand the major duties of the position.

PREFERRED REQUIREMENTS:

  • Associate degree and one (1) year of relevant administrative office support; or a high school diploma or equivalent and three (3) years of relevant administrative office support experience sufficient to understand the major duties of the position.

To apply, Click Here