PRC Technician

Essential Job Functions: Issue on-line PRC authorization forms daily for payment to contract and non-contract providers for health care services provided to eligible tribal member patients. Determines appropriate coding/accounting data. Tracks and verifies patient referrals for proper eligibility and documentation. Screens all requests for payment of medical/dental care services for other resources such as Medicare, Medicaid, private insurance, Veteran's Administrations, Industrial Accident, BEC, etc. Initiates follow up with fiscal pending claims, delayed payments, and other pertinent documents/information. Sends letters to patients and health care providers regarding bills and scope of services available. Maintains correspondence regarding PRC program, includes copies of denial letters to providers, etc. Assure all outstanding authorizations over ninety (90) days old are valid; others are canceled and funds are re-obligated before the end of the fiscal year. Share on-call Patient Travel responsibilities as scheduled.

Knowledge, Skills, and Abilities: Knowledge of the Health Insurance Portability and Accountability Act (HIPAA); Skill to operate software programs; Ability to obtain personal information (demographics, employment, insurance information) from clients in a respectful and skilled manner. Ability to communicate professionally over the telephone and in person in a positive and clear manner; Ability to manage multiple tasks, including telephone, computer operations and in-person visits simultaneously; Ability to take verbal instruction and complete assigned project by established deadline; Ability to be flexible in order to perform at the highest level as a team player; Ability to utilize maximum degree of professionalism and diplomacy with those who may be experiencing a high degree of stress both mentally and/or physically (both patients and co-workers); Ability to work independently with minimal supervision and able to prioritize assignments; Ability to maintain confidentiality of all KIC operations and staff.

Physical Activities: Must be able to work in an office environment in a stationary position the majority of the workday. This position needs to occasionally move about inside the office environment to access office equipment, attend face-to-face meetings on / off site as needed, zoom meetings, teleconference calls, videoconferencing, e-mail, and similar activities, etc. Routinely lifting and carrying items and boxes up to ten (10) pounds. Large portion of time will be spent in front of computer screen, researching and reviewing various documents for final disposition to internal / external customers. Writing by hand and using a personal computer. Traveling occasionally, to out-of-town meetings and functions.

Working Conditions: The environment involves the usual risks and stress of an office environment within a public service facility. The employee may be exposed to communicable diseases. Safety precautions for employees such as blood drawing for screening of various diseases such as hepatitis, required immunizations, etc. are necessary. The employee is occasionally subject to verbal abuse, threats, and physical violence from angry, hostile, or disgruntled patients and/or family members.

KIC Competencies: Cultural Competency: To be respectful and responsive to the health beliefs, practices, and cultural and linguistic needs of KIC Tribal Members. Developing cultural competence is an evolving, dynamic process that takes time and occurs along a continuum. Commitment: To serve Tribal Members and set a high standard for yourself in your performance; strive for results and success; convey a sense of urgency and bring issues to closure; and stay persistent despite obstacles and opposition. Customer Service: Meet/exceed the expectations and requirements of internal and external customers; identify, understand, and monitor the needs of both internal and external customers, always talk and act with customers in mind; and recognize working colleagues as customers. Effective Communication: Ensure important information is passed to those who need to know; convey necessary information with respect, clearly and effectively orally or in writing Responsiveness and Accountability: Demonstrate a high level of conscientiousness; hold oneself personally responsible for one's own work; and do the required fair share of work.

Licensure: Possess current valid State of Alaska driver's license with a record acceptable to KIC's Insurance carrier.

Education: High school diploma or equivalent required. Prefer individual with medical terminology training, knowledge of Contract Health Service rules and regulations.

Experience: Progressive responsible clerical, office or other work that indicates ability to acquire the particular knowledge and skills needed to perform duties of this position. Minimum one-year general office experience.