JOB SUMMARY: Provide technical support to the PRC program within the Purchased/Referred Care delivery area (PRCDA) for the unassigned patients within the Shawnee Service Unit. These patients reside in the Cleveland, Oklahoma, and Logan Counties.
PRIMARY DUTIES:
- Coordinate correspondence for PRC patients.
- Utilize appropriate screening tools with patient during discussions to identify applicable alternate resources for our patients to apply and/or have pay for care prior to PRC.
- Provide PRC orientation to health service providers, and recipients, to ensure that they possess a good understanding PRC requirement.
- Required to have excellent communication skills and optimize customer service opportunities by how and when the call center calls are answered, as well as, all face to face communications within the Oklahoma City Area Office building, and any alternate location(s) they will be representing Indian Health Service.
- Scheduling requirements include: coordinating PRC referral appointment timely, acquiring date(s) of service for payment and issuing obligation for all associated charges related to care.
- Must quickly acclimate themselves to the electronic systems utilized in PRC for administering the PRC program.
- Duties may include the monthly resolution to the undelivered purchase orders that are older than 365 days from issuance (excluding reconciliation actions), monthly and/or weekly work on the Fiscal Intermediary Pend Report, monthly report of all purchase order actions, daily report for purchase orders issued in the morning, ensuring purchase orders are signed daily, processing EOBRs daily and closing/exporting daily. Other data reports, as requested.
- Duties may include assisting with the coordination of the Catastrophic Health Emergency Fund (CHEF) for the Shawnee Service Unit PRC program.
- Duties and responsibilities during this contract period may be changed as frequently as warranted due to team skillset changes and program needs during periods of turnover/onboarding/reorganization within the PRC program.
- Duties may include the responsibility of coordinating the new weekly purchase order report to providers and/or the all purchase order report that must be sent out to providers every other month.
- Required to maintain strict confidentiality in responding to inquiries and communication within scope of position.
- Must adhere to all record management requirements for PRC documents of record.
- Performs other related PRC projects for program success, timely.
EDUCATION/CERTIFICATION:
- Background check required.
SECURITY CLEARANCE:
- Public Trust
Qualifications
ABOUT US: At MCSG Technologies, we believe the path to success begins by empowering our employees to do what is best for our customers. This helps create value for our customers and business partners through efficiencies and cost-effective relationships that are built on trust, while delivering on-time and within budget. Our company ethos is simple Empowered to serve our customers, our communities, our colleagues. If you would like to learn more, please visit our website at or find us on Glassdoor.
BENEFITS OFFERED: Medical, dental, vision, life insurance, short-term disability, long-term disability, 401(k) match, flexible spending accounts, EAP, parental leave, paid time off, holidays and more. Learn more about MCSG Technologies benefits: .
COLORADO'S EQUAL PAY ACT : In compliance with Colorados Equal Pay for Equal Work Act; MCSG Technologies considers several factors when extending an offer, including but not limited to, the role and associated responsibilities, a candidate's work experience, education/training, and key skills.
EOE STATEMENT: We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, disability status, protected veteran status or any other characteristic protected by law.
EXECUTIVE ORDER 14042 ENSURING ADEQUATE COVID-10 SAFETY PROTOCOLS: The United States government may require that all employees, plus all contract employees performing services on behalf of the federal government, be fully vaccinated against COVID-19. In accordance with EO 14042, MCSG Technologies may require that all employees with MCSG Technologies be fully vaccinated against COVID-19.