Employment Opportunities
PRC Billing Specialist
This position is currently open.
Public?:
Internal
Division:
Health
Reports To:
PRC Director
Type of Position:
Regular Full Time
Location:
Little Axe Health Center / 15951 Little Axe Dr. / Norman, OK 73026
General Description
The purpose of this position is to serve all of the AST Health System. The AST Health System is an ambulatory health system that currently serves patients with Insurance (Indian and Non-Indian), Absentee Shawnee Tribal Citizens, and Absentee Shawnee Tribal employees and other Native Americans. This position is located at the Little Axe Health Center in Norman OK, within the Purchased Referred Care (PRC) Department.
Responsibilities & Duties
Performs clerical assistance including typing, processing patient referrals, retrieval of records and inputting fiscal and statistical data in a data base.
Manage eligible Tribal members’ profiles, including intakes, updates, consents and other important information.
Provides information in person or by telephone regarding services available under the Absentee Shawnee Tribe’s Health Programs.
Responds to PRC inquiries and requests for PRC assistance. Such responses are through telephone, correspondence, and personal visits with consumers.
Develops and maintains a positive working relationship and supports the overall team effort of the Absentee Shawnee Tribal Health program providers including clinics, physicians, community outreach programs, third party resources, community health care nurses, home health care nurses, diabetes initiative, behavioral health, billing office, health board and CM review committee.
Enters, updates, and verifies all alternate resource data necessary for patient and third party payers; verifies insurance coverage; obtains signatures for file on forms for alternate resources.
Performs routine clerical duties including processing incoming and outgoing mail, logging all incoming calls, copying all necessary documents, filing, and maintains mailing lists.
Responsible for the performing software updates in software newly acquired by PRC replacing Prometheus.
Point of contact liaison with Plexis programmer.
Manage Tribal members’ profiles, including updates, consents and other important information are added and imported from old software.
Delivering documents and interoffice mail to appropriate departments.
Responsible for maintaining documents for filing of vendor invoices and mailing denials.
Responsible for the correct processing of all medical claims.
Provides information in person or by telephone regarding services available under the Absentee Shawnee Tribe’s Health Programs.
Responds to CHS inquiries and requests for CHS assistance. Such responses are through telephone, correspondence, and personal visits with consumers.
Develops and maintains a positive working relationship and supports the overall team effort of the Absentee Shawnee Tribal Health program providers including clinics, physicians, behavioral health, billing office.
Verifies all alternate resource data necessary for patient and third party payers; verifies insurance coverage; obtains signatures for file on forms for alternate resources.
Performs routine clerical duties including logging all incoming calls, copying all necessary documents, and filing.
Enters client data into the appropriate database; maintains accurate files, and organizes data.
Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
Attends health orientation, HIPAA training, safety training and other health system training needed to be competent in their position.
Performs other duties assigned.
Education Requirements and Qualifications
High School graduate or GED.
3 or more years’ experience as a medical or business office setting
Prefer experience as a medical claims processor.
Prefer completion of a program or training in Medical Office Technology or a related field.
Experience with electronic health record (EHR) software preferred.
Must be computer be literate
Knowledge, Skills and Abilities
Incumbent must possess the ability to interact with a wide variety of individuals and handle several complex situations simultaneously. It also requires impeccable communication and negotiation skills, written and verbal, and excellent computer and typing skills. Must be able to provide quality customer service. Must be able to apply critical thinking through the ever changing work environment. Knowledge of software to access and interpret patient data.
Excellent verbal and written communication skills.
Ability to communicate with patients, families, caregivers and other healthcare professions.
Culturally sensitive to Native Americans.
Good organizational and assessment skills.
Self-motivated.
Must be able to prioritize work tasks and be creative with projects.
Must be able to fully utilize a computer.
Must be able to perform duties with a minimum of supervision.
Must be able to function as a team member.
Must be able to be a dependable team member of the clinic setting and be ready to start work on time.
Must be able to be sedentary for long periods of time, will require a majority of sitting time.
Must be able to work in an office setting with public interaction and exposure to potential illnesses.
Must possess a valid Oklahoma Driver’s license.
Must be able to pass a background check and drug screen.
Physical Requirements and Working Conditions
Must be able to sit, stand, stoop, bend or kneel for long periods of time.
Sitting or standing or walking for long period of time; occasional bending, squatting, kneeling, stooping; good finger dexterity and feeling; frequent repetitive motions; talking hearing and visual acuity.
Frequent lifting (up to 15 lbs)
Occasional lifting (up to 30 lbs)
The Absentee Shawnee Tribe of Oklahoma (AST) is committed to Equal Employment without regard to race, religion, color, gender, national origin, age, disability, or sexual orientation. However, in accordance with the Indian Preference Act (Title 25 U.S. Code 472 and 473) preference in filling vacancies are given to qualified Indian candidates. AST will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990 and its amendments.
Native American Preference/EEO/Drug Free/Smoke Free Workplace
Posted Date:
1 week 3 days ago