What are the responsibilities and job description for the Purchased Referred Care Coordinator (PRC) position at Greenville Rancheria?
Job Description
All Greenville Rancheria employees pay little to no cost for their medical and dental needs if they use our providers.
PURCHASED REFERRED CARE COORDINATOR
POSITION SUMMARY: The Purchased Referred Care Coordinator (PRC) is under the direction of the PRC Supervisor at the Red Bluff clinic and the Executive Director (ED). The PRC Coordinator, coordinates medication, testing services and professional provider referrals for the Native Americans in the Greenville Rancheria, Greenville, California service area based on the PRC Policy and Procedure manual.
General Duties and Responsibilities:
- Maintain a positive, pro-active, and professional demeanor with fellow employees.
- Work under pressure in a fast-paced clinic environment.
- Make sound decisions and take responsibility.
- Maintain good attendance and be punctual.
- Be task oriented in all work activities, while meeting deadlines.
- Read and adhere to policies and procedures.
- Agree to and sign a conflict-of-interest form and agree to not disclose any trade secrets, directly or indirectly, or use them in any way, either during the term of employment or at any time thereafter, except as required in the course of employment with Greenville Rancheria.
- Always maintain a high-level of employee, patient/family confidentiality.
- Computer skills, such as NextGen, i2i, Excel, PowerPoint, Microsoft Teams, Zoom, Outlook, etc.
- Must be able to use office equipment including fax, multi-line telephone and copy machine.
PRC Direct Duties:
- Determines eligibility of Natives for PRC services.
- Registers all patients in accordance with the Greenville Rancheria and Indian Health Services (IHS) polices into the NextGen Contracted Health Referral system (CHRS) computer system.
- Documents Native eligibility such as electric bill, Bureau of Indian Affairs (BIA) card or California Native card.
- Processes requests in a timely manner.
- Classifies requests with-in the five levels of care and approves those with in the proper levels.
- Maintains records of denials and approvals.
- Notifies patients of approval or denials.
- Sends approval requests to the Fiscal Department for payment.
- Keeps accurate billing records of expenditures and obligations and attempts to maintain a balanced budget.
- Apply to the IHS area office for Catastrophic Health Emergency Fund payment of bills over $25,000.
- Instructs hospitals to pay Medicare rates.
- Completes annual Unmet Needs Data Report for the IHS area office.
- Other duties as assigned.
Job Type: Full-time
Pay: $19.00 per hour
Expected hours: 40 per week
Benefits
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
- Weekends as needed
Education:
- High school or equivalent (Required)
Work Location: In person
Job Type: Full-time
Pay: $19.00 per hour
Benefits:
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work Location: In person
Salary : $19
