Contact Representative (PRC)

Duties

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Apply and interpret federal, state, Tribal, and private-sector regulations to determine patient eligibility and funding for healthcare programs.

Analyze medical, financial, and eligibility documentation to resolve complex benefit, authorization, and coverage issues.

Issue medical authorizations or denial determinations and coordinate with patients, providers, and agencies to support continuity of care.

Maintain fund control records, monitor expenditures, apply accounting codes, and resolve program or funding discrepancies.

Compile and analyze reports related to program operations, funding, and utilization.

IHS Selectees whose duties and responsibilities require them to work permanently, temporarily, or occasionally in an IHS healthcare facility must comply with the IHS Employee Immunization Policy related to vaccine-preventable diseases, consistent with recommendations for healthcare workers. Vaccine exemption requests may be available, as outlined in the IHS Employee Immunization Policy and facility guidance.