This position serves as the Purchased Referred Care Assistant (PRC) for the Claremore Indian Hospital in Claremore, OK. The individual is responsible for providing support for the administration of the PRC program. This position reports to the Supervisory Health Systems Specialist of the PRC Department.

Duties

Determining patient eligibility and responding to inquiries and requests for PRC assistance. Maintaining a follow-up system that will ensure effective and maximum utilization of PRC funds. Assists with reporting of Catastrophic Health Emergency Fund (CHEF) cases by obligating these funds as quickly as possible. Explains regulations and policies to health service providers, recipients, and staff. Entering and verifying all PRC payments, cancellations, and supplements into a computer application.

Requirements

Qualifications

To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week. MINIMUM QUALIFICATIONS: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: BASIC REQUIREMENT(S): In addition to the Basic Requirements, you must also meet the Minimum Qualifications stated below. GS-06: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-05 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: interviewing patients, updating patient registration information, verifying third-party resources, utilizing patient registration systems, working with various health benefit programs and health insurance programs having different benefits, deductibles and eligibility requirements, and initiating and completing application for third party resources GS-07: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-06 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Perform periodic spot reviews and audits of completed authorization forms; maintain an effective follow up system and maximum utilization of funds; Assure Adequate funds are set aside for all authorized referrals; Assure all funds have been obligated; Assure all outstanding authorization are valid; Assure authorization are processed. Time In Grade Federal employees in the competitive service are also subject to the Time-In-Grade Requirements: Merit Promotion (status) candidates must have completed one year of service at the next lower grade level. Time-In-Grade provisions do not apply under the Excepted Service Examining Plan (ESEP). You must meet all qualification requirements within 30 days of the closing date of the announcement.

Education

There are no education requirements.

Contacts

• Address Claremore Service Unit 101 S Moore Claremore, OK 74017 US
• Name: Jennifer Miller
• Phone: 785-832-4885
• Email: [email protected]