Prc Assistant - Lakeport, United States - LAKE COUNTY TRIBAL HEALTH CONSORTIU

LAKE COUNTY TRIBAL HEALTH CONSORTIU

Verified Company

Lakeport, United States

2 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

TITLE:

PRC ASSISTANT

DEPARTMENT:

FISCAL

SUPERVISED BY:

PRC MANAGER

CLASSIFICATION:
NON-EXEMPT

***: Assists the PRC Coordinator with managing the Purchased/Referred Care (PRC) program as prescribed by the Indian Health Services (IHS) / California Area Office (CAO) Manual, as well as additional services as may be officially designated.

ESSENTIAL FUNCTIONS:

Closely adheres to policies and procedures as contained in the Lake County Tribal Health PRC Manual, the Indian Health Service PRC Manual, 42 Code of Federal Regulations parts 36 and 36a, and the Indian Health Care Improvement Act.
With approved IHS level of care category, and as may be supplemented by the Board of Directors
Verifies that patients are eligible for PRC Services and/or other services and programs as assigned
Provides billing information to the pharmacy by stamping prescriptions according to the patients eligibility status
Maintains close communication with the pharmacy to allow 1x non-formulary Rxs for eligible patients, authorizations for patients with active referrals and other information as needed
Contacts providers to obtain all necessary billing information (UB-04s/HCFAs and EOBs) in order to make payment on PRC services
Contacts patients as needed to obtain current insurance information and/or income verification
Prints out all PRC POs and submits to A/P on a weekly basis
Maintains close communication with providers to ensure timely payment of authorized services
Provides PRC and other program eligibility information to patients as needed
Other duties as assigned

EXPERIENCE, EDUCATION, CERTIFICATIONS AND LICENSES

High School Graduate or GED
Must possess a high level of competency in organizational, communication and interpersonal skills
Ability to establish and maintain effective working relationships with the general public, co-workers, elected and appointed officials and members of diverse cultural and linguistic backgrounds regardless of race, religion, age, sex. Disability or political affiliation
Ability to prepare and express ideas in writing and verbally
Ability to understand and carry out oral and written instructions
A valid California Drivers license is required
Must be available for occasional travel to conferences, seminars and training
Knowledge of the regulations regarding client confidentiality
CPR certification required after employed
Computer literate

All LCTHC employees are expected to:

Provide the highest possible level of service to clients;
Promote teamwork and cooperative effort among employees;
Maintain safe practices; and
Abide by the LCTHC policies and procedures as they may from time to time be updated.

PHYSICAL DEMANDS:

INDIAN PREFERENCE:

Preference may be given to qualified Native American Indians according to the Indian Preference Hiring Act, CFR 25 USC 472.

Other than Indian Preference, Lake County Tribal Health Consortium, Inc. adheres to all provisions of the Equal Employment Opportunities Act.

NOTICE OF DRUG-FREE WORKPLACE ACT REQUIREMENT: LCTHC is committed to maintaining a drug free and alcohol free workplace. LCTHC believes that a healthy, productive workforce free from the effects of drugs is very important to all employees and patients. Substance abuse is incompatible with the health, safety, efficiency and the success of LCTHC. Employees who are under the influence compromise LCTHC?S interests, endanger their own and the health and safety of others and can cause a number of other work-related problems. As a condition of employment, each applicant receiving a job offer from LCTHC must take and pass a required drug screen test.

HIPAA Health Insurance Portability and Accountability:
This act was enacted to deal with three main areas with regard to patient information.

Security of health information
Standards of electronic transactions
Privacy of individually identifiable health information

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform.

The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Lake County Tribal Health is an At-Will Employer.

Either the employee or LCTHC can terminate the employment at will, without advance notice, at any time, with or without cause.