PRC Technician

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Full Time Kewa Pueblo Health Corp, Kewa Pueblo, NM, US

Salary Range: $20.56 To $32.57 Hourly

PRC Tech

Department: Purchased Referred Care

Reports to: Director of PRC

FLSA Status: Non-Exempt

Type of Position: Full-Time

The Kewa Pueblo Health Corporation (KPHC) is established for the purposes of carrying out the vision and mission of the Santo Domingo Health Center (SDHC). The MISSION of KPHC is: “ENSURING HEALTH & WELLNESS THROUGH EXCELLENCE IN HEALTHCARE WITH RESPECT FOR CULTURE” and the VISION OF KPHC is: “HEALTHY PEOPLE, HEALTHY COMMUNITY, and HEALTHY LIFESTYLE”.

The purpose of this position is to provide a full range of services related to contract health, business office, medical records, and clinic administration.

In performance of their respective tasks and duties all employees of the Kewa Pueblo Health Center are expected to conform to the following:

• Uphold all principles of confidentiality and patient care to the fullest extent.
• Adhere to all professional and ethical behavior standards of the healthcare industry.
• Interact in an honest, trustworthy and dependable manner with patients, employees and vendors.
• Possess cultural awareness and sensitivity.
• Comply with all Kewa Pueblo Health Corporation and Santo Domingo Health Center policies and procedures, as well

• Determines patient eligibility for care under the PRC Program. Requires the application of PRC rules and regulations on PRC delivery areas. Determines patient eligibility as a prerequisite to authorization of funds and requires making accurate and independent decisions for the provision or denial of payment for services based upon eligibility criteria.
• Defines alternate resources available to patients under the PRC Program and independently determines patient eligibility for Medicare, Medicaid, Veterans Administration, Medical Services, private insurance, state programs, and any other applicable resource. Thorough working knowledge of various Third Parties, such as Medicare, Medicaid, Private Insurance, etc., availability of health care resources, rules of eligibility for medical and other available programs to assist in payment of health care costs.
  
  Contacts alternate resource agencies, conducts personal interviews with patient and/or family members to determine potential eligibility for any alternate resources, and works as a liaison between patient and outside provider/ resource regarding follow up care and eligibility of coverage.
• Participates in determinations of reasonableness of rates by non-IHS providers and contractors of PRC by providing appropriate data and other input.
• Performs patient services related to follow-up care, diagnostic procedures, and referrals to medical specialist for consultation and/or treatment. Schedules appointments and /or multiple appointments based on schedules, availability of doctors, nature of treatment and /or emergency, the logical sequence of required tests and x-rays, and the amount of travel time required by the patients.
• Instructs a patient regarding necessary medical preparation prior to receiving treatment. Notifies appropriate personnel of scheduled appointments and of medical records and files required documentation. Notifies patient of medical follow-up as requested by the clinician and for cancelled and /or rescheduled clinics.
• Disseminate information through proper channels in accordance with established procedures and performs other general clerical tasks necessary in carrying out patient appointment functions.
• Obtains…