Medical Assistant - PRC - Clinton - IHS

JOB SUMMARY

Provide Medical Assistant services for the PRC Department at the Clinton Indian Health Center as described under responsibilities below. Contractor shall provide other duties as assigned within the Clinton Service Unit.

• Responsible for verifying patient eligibility in receiving routine Medical Referrals and/or emergency call‑ins for treatment rendered by reviewing documentation in the patient registration regarding eligibility and alternate resources availability for services rendered. Incumbent maintains and utilizes the Resource Patient Management System (RPMS), Electronic Health Record (EHR) and the Referred Care Information System (RCIS) in reviewing documentation.
• Responsible for coordination of and provision of patient education regarding the PRC program and associated requirements for eligibility. Interviews and evaluates patients for possible eligibility of an alternate resource, i.e. Medicare, Medicaid, Veteran’s Administration, and other private insurance carriers. Ensures patients are referred to the Patient Benefit Coordinator for further assistance.
• Responsible for interpretation of medical bills and explanation of benefits received from patients and medical providers. Reviews all incoming correspondence from providers.
• Assist in processing all authorizations and provides information to the Fiscal Intermediary, Blue Cross Blue Shield of New Mexico, regarding authorization of payment. Responsible for determining if an authorization has been issued or has been paid.
• Responsible for collecting accurate health insurance information from patients to ensure IHS is payer of last resort.
• Assists in scheduling of patient appointments for PRC referred care and ensures proper follow‑up with the vendor so that patient care is coordinated in a seamless fashion.
• Assist in patient inquiries, both in person and via phone, and ensures each inquiry is answered in a timely and customer‑service friendly manner.
• Ensures patients are informed on the priorities for services based on policy and procedure of the Clinton Indian Hospital IHS PRC program. Greets patients for services at the department window, issues the patient forms to such patients and assists them in the completion of the forms.
• Answers incoming department phone calls, responds to voicemail messages left by staff and patients for the departments, and calls out to staff and patients as needed for the purposes of relaying pertinent information for patient care coordination.
• Other duties as assigned.

• Background check required.

• Public Trust

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.