General Practice Indian Health Reservation job located in Oklahoma

• Looking for a Medical Assistance in support of Indian Health Services in Claremore, OK.
• Come join a company that strives for Extraordinary People and Exceptional Performance!
• To view the full job description and apply, visit: (Login for Information)

To view the full job description and apply, visit: (Login for Information)

Come join a company that strives for Extraordinary People and Exceptional Performance! (Login for Information) Government Mission Solutions, LLC, a (Login for Information) Professional Services’ company, is looking for a Medical Assistance in support of Indian Health Services in Claremore, OK. The Claremore Indian Hospital (CIH), Indian Health Services (IHS) has a requirement for a Full-time Medical Support Assistants that will provide support and technical assistance to the service unit PRC Manager on matters involving Purchased Referred Care including medical, surgical, hospital and clinical services to all eligible beneficiaries in conjunction with or in lieu of IHS facilities.Our company offers employees the opportunity to join a team where there is a robust employee benefits program, management engagement, quality leadership, an atmosphere of teamwork, recognition for performance, and promotion opportunities. We actively strive to channel our highly engaged employee’s knowledge, critical thinking, innovative solutions for our clients.

• Receive referrals for emergency call-in status, initiates medical authorizations to include hospitalization and professional fees for eligible IHS patients.
• Maintain denial/deferral correspondence files assuring that all appropriate documentation is included in file.
• Coordinate patient appointments with contracted vendors for Medicare rates of reimbursement in the delivery of referral management.
• Provides PRC orientation to health service vendors, and recipients, as well as service unit personnel, to insure that they possess a good understanding of the program methods, policies, procedures and regulations.
• Conduct on –site patient interviews to establish eligibility and complete and maintain application for medical care. Verify records of residence for applications by addressing inquires to a variety of sources.
• Review incoming invoices to determine if authorizations have been issued and if not, incumbent researches and takes appropriate action.
• Verify referral management eligibility for Indian patients using PCR regulatory criteria and determines patient eligibility for third party alternate resources.
• Reviews Fiscal Intermediary pending lists and follow up on requirements for service unit action.
• Participate in PRC Review Committee Meetings regarding approval for PRC services.
• Key data into the PRCMIS data system for issuing purchase orders.
• Participate with the Health System Specialist in the development of local PRC procedural guides, compile and interpret various alternate resource references and guides.
• Provide support in the development and presentation of the local preliminary and supplemental PRC budget.
• Answer telephone and written inquiries regarding eligibility requirements, payments, outstanding charges, and other questions concerning the PRC Program. Maintain strict confidentiality in responding to inquiries. Prepare routine correspondence and compile information for periodic special reports.
• Type material from draft form using word processing automation. Maintain appropriate files and perform other office clerical support work as required.
• Key data information for automatic document control commitment register for the health services funds allotted, which requires accurate accountability and comprehensive knowledge of fiscal coding procedure. Provide the supervisor informal reports on undelivered purchase order status expenditures on periodic basis.
• Contact stage agencies and other outside organizations to determine medical eligibility within the service unit jurisdiction. Cross compare proposed authorization with sources prior to obligating funds for referral management services.
• Receive visitors and phone calls to the PRC Department, ascertaining the nature of requests and directing callers to appropriate staff, or personally providing the information desired when routine or procedural matters of the office are involved.
• Incumbent is responsible in making determinations as to patient eligibility and scope of care for referral management. Explain/clarify to the patient an understanding of policies, direct/PRC eligibility and third party billing practice, alternative resources – Medicare, Medicaid, Private Insurance, and Affordable Care Act.
• Qualified typist
• 1 year of experience in medical office
• Proficient with MS Office Suite
• Referring/answering calls and questions
• Determine eligibility for service
• Assemble PRC referrals in their required order and sequence for Alpha letter distribution
• Alternative resources – Medicare, Medicaid, Private Insurance, and Affordable Care Act.
• Medical procedures, various medical specialties and medical terminology are needed to coordinate patient care with contracted vendors.
• Retrieve a variety of physicians’ orders for patient activities, diets, tests, and treatments
• Research/refer patients to appropriate clinics for care
• Answer questions regarding routine procedures
• Relay instructions to patients on referred care decisions
• File referred care results and distribute to appropriate staffs for purchase order (PO) assignment
• Relay information regarding the patient’s referral status
• Compiling/submitting data on referred care and treatment plans
• Excellent written and oral communication skills