Contact Representative (PRC)
Department of Health and Human Services
Job Title
Help
Duties
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.
- ...Contact Representative Join the Indian Health Service as a Contact Representative and support access to healthcare services for American Indian communities. Assist patients with eligibility, medical authorizations, referrals, and healthcare benefits while building...Suggested
$69k
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- Job Title Help Job Description Reviews medical records for completeness, including required identifiers, signatures, dates, and reports associated with services rendered. Evaluates documentation for accuracy, consistency, medical necessity, and appropriate ...
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