PRC (Purchased Referred Care) Technician US Based Applicants Only; Sponsorship Not Available

Job Description

Job Description

Position Summary The PRC Technician supports the Purchased/Referred Care department by performing clerical duties, processing referrals, verifying patient eligibility, and coordinating required documentation for prior authorizations. This position ensures timely and accurate data entry, effective communication with patients and providers, and strong adherence to confidentiality and compliance standards.Key ResponsibilitiesRequest, collect, and review medical documents from providers.Verify primary insurance, alternate resources, and contract health eligibility.Initiate and distribute medical authorizations; determine patient eligibility for direct and contract services.Maintain tracking systems for high-cost cases and CHEF fund submissions.Organize and maintain denial correspondence files with complete documentation.Conduct patient interviews to verify residence and eligibility.Participate in CHS review committee meetings.Manage and update patient profiles, consents, and documentation required for referrals and prior authorizations.Respond to PRC inquiries by phone, correspondence, or in person.Provide information regarding PRC services to patients and community members.Enter and maintain accurate client data and organized files.Uphold strict confidentiality and compliance with HIPAA regulations.Perform other duties as assigned.QualificationsHigh School diploma or GED.Minimum 3 years of clerical or receptionist experience in a medical or business setting.Experience with Electronic Health Records (EHR) preferred.Strong communication, organizational, and computer skills.Ability to manage complex situations, apply critical thinking, and work independently.Culturally sensitive to Native American populations.Self-motivated and able to prioritize tasks effectively.APPLICATION REQUIREMENTS:Submit a completed application with supporting documents via the online portal at warmvalley.health.Applications are available at Warm Valley Health Care or for more information contact Stacie Fagerstone, Executive Director-HR via email at View email address on us.fitly.work will be given to qualified Eastern Shoshone tribal members, then other qualified federally recognized Indian tribal members and then other qualified candidates.Applicants must submit a copy of Tribal Enrollment card or CIB for Indian Preference.Veterans who meet the minimum qualifications and provide documentation of an honorable discharge (DD214) from any branch of military service are entitled to receive preference points during the interview process.Any offer of employment is contingent upon a negative drug test, reference checks and background check. Refusal to undergo required testing or testing positive will render the applicant ineligible for employment.EOEMust pass pre-employment drug screening.Successfully pass the employment background check.