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The Medical Assistant is primarily responsible for providing services for the PRC Department, which includes verifying patient eligibility for routine Medical Referrals and emergency treatments by reviewing documentation and maintaining various patient management systems. Key duties also involve coordinating patient education regarding the PRC program, evaluating eligibility for alternate resources like Medicare/Medicaid, interpreting medical bills, and processing authorizations.
Requirements summary
Candidates must successfully pass a background check and possess the necessary qualifications for a Public Trust security clearance. Responsibilities require proficiency in utilizing systems like RPMS, EHR, and RCIS, along with strong skills in patient interviewing, insurance interpretation, and providing timely, customer-service-oriented assistance.
Documentation ReviewCustomer ServicePatient EducationElectronic Health RecordAppointment SchedulingInsurance Information CollectionInquiry HandlingInsurance InterpretationMedical ReferralsExplanation of BenefitsAuthorization ProcessingPatient Eligibility VerificationResource Patient Management SystemReferred Care Information SystemAlternate Resource EvaluationMedical Bill Interpretation
Job description
Job DetailsJob Location
IHS
Clinton -
Clinton,
OK 73601Position
Type:
Full
TimeJob
Category:
Health
CareJOB
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.
PRIMARY
DUTIES: 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 processes 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 appointment for PRC referred care and ensures proper follow up with the vendor to ensure patient's care is coordinated in a seamless fashion. Assist in patient inquires, both in person and via phone, and ensures each inquiry is answered in a timely and customer service friendly approach. 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, responding to voicemail messages left by staff and patients for the departments, and calling out to staff and patients as needed for the purposes of relaying pertinent information for patient care coordination. Other duties as assigned.
QualificationsABOUT US: At MCSG Technologies, we believe the path to success begins by empowering our employees to do what is best for our customers. This helps create value for our customers and business partners through efficiencies and cost-effective relationships that are built on trust, while delivering on-time and within budget. Our company ethos is simple Empowered to serve our customers, our communities, our colleagues. If you would like to learn more, please visit our website at www.mcsgtech.com or find us on Glassdoor.
Benefits
OFFERED: Medical, dental, vision, life insurance, short-term disability, long-term disability, 401(k) match, flexible spending accounts, EAP, parental leave, paid time off, holidays and more.
ACT: In compliance with Colorados Equal Pay for Equal Work Act; MCSG Technologies considers several factors when extending an offer, including but not limited to, the role and associated responsibilities, a candidate’s work experience, education/training, and key skills.
EOE
STATEMENT: 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.
PAY
Transparency
Nondiscrimination
PROVISION: The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractors legal duty to furnish information. 41 CFR 60-1.35(c)
