PRC Clerk

Job Description

Job Description

Benefits include:

• Monday - Friday (No weekends and no holidays)
• Health, dental, and vision full coverage for individual - Family option available
• Short term/long term disability options
• Vacation (annual) + PTO (accrued weekly)
• 16 paid holidays in the calendar year
• 401K - 5% matching
• Parental, medical, education, bereavement leaves and so much more!

BASIC FUNCTION : 

The Clerk is responsible for performing administrative tasks and duties to support daily Purchased Referred Care (PRC) department operations. The incumbent will ensure all Indian Health Services (IHS) and Seneca Nation Health System (SNHS) policies and procedures are followed correctly pertaining to eligibility and payment.

GENERAL RESPONSIBILITIES:

1. Verifies eligibility for PRC payment, including referral, ER reported, patient status, etc. on all claims received.
2. Validates all patients’ bills/statements received for eligibility for payment along with patient insurance.
3. Processes any additional claim status information as requested, such as date paid, amount, check information, etc.
4. Researches patients’ bills and reports finding to PRC Manager.
5. Processes and files all incoming and outgoing department mail.
6. Generates and maintains records of denial letters.
7. Responsible for incoming phone calls and email correspondence from patients and outside providers.
8. Maintains accurate filing for fiscal year records.
9. Voids purchase orders through direct approval from PRC Manager.
10. Upholds and promotes the value and integrity of the Seneca Nation Health System’s mission statement. Will promote SNHS in a positive manner.
11. Provides team collaboration through a trauma-informed lens by incorporating key principles of both physical and psychological environment safety, trustworthiness and transparency, collaboration of decision-making during departmental plan developments, empowerment of co-workers by recognizing and building upon individual strengths, as well as recognizing and respecting the diversity of cultural backgrounds and sensitivity.
12. Participates and completes all mandatory staff trainings, meetings, and in-services.
13. Follows all policies and procedures of the department, SNHS, and Seneca Nation.

KNOWLEDGE, SKILLS, & ABILITIES:

• Excellent verbal and written communication skills.
• Exceptional interpersonal and organizational skills.

QUALIFICATIONS:

• High School Diploma or equivalent required.
• 2 years’ experience in office setting preferred.
• Experience in a large hospital, academic medical center, outpatient health care setting, or Indian Health Service (IHS)/tribal health, preferred.