PRC Claims Analyst, Purchased​/Referred Care

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Full-Time Regular H.F.T. Uncasville, CT, US

Summary of

Job Description:

Incumbent in this position reviews, evaluates and processes requests for assistance made to the Tribal Purchased/Referred Care program.

• Knowledge of IHS Purchased Referred Care Programs & Services or ability to learn
• Knowledge of medical terminology, ICD-10 and CPT coding
• Knowledge of Medicare, Medicaid and other payers' reimbursement policies and procedures
• Intermediate Word and Excel skills (skill level determined by testing)
• Strong knowledge of claims adjudication or Electronic Health Record (EHR) systems
• Strong organizational skills
• Ability to maintain strict confidentiality

Education, Experience and Training:

• High school diploma
• Three (3) years' experience in medical coding or billing
• Two (2) years' experience with either Electronic Health Record (EHR) or electronic billing/payment system

~OR~

• High school diploma
• Certified Professional Coder (CPC) or Certified Professional Biller (CPB) or both
• One (1) year of experience in a customer-facing or data-entry role in any medical office setting

The Mohegan Tribal Government is committed to Native American Preference and is an Equal Opportunity Employer.