Job Descriptions:

Salary:

$21.00- $24.45, depending on experience!

Benefit Highlights:

• Employee annual raises when meeting or exceeding job expectations

• Employer-paid Health Insurance (medical, dental and vision): 100% for employee and 80% for dependents.

• 17 days PTO per year

• 11 Paid Holidays

• Retirement Plan with 6% match

• Fantastic work/life balance

• Opportunities for career advancement

The Purchased & Referred Care Coordinator is responsible for carrying out the day-to- day operations in accordance with the established directives, policies, and procedures regarding purchased and referred care. They are responsible for lab bill analysis and to ensure codes are correctly allocated by working directly with external lab vendors, insurance providers, patients, and medical staff. The PRCC manages the allocation of funding resources. They track Medical, Dental, Pharmacy, Behavioral Health and Optometry claims through to completion and reports on utilization metrics to supervisors.

Purchased & Referred Care Coordinator

• Process monthly Quest Lab invoice, track individual programs i.e., LLC, DPP, PRC and other programs as needed.

• Process daily trailers and patient billing as received by Quest and/or patients, make coding updates as needed and resubmit claims for billing.

• Interpret PRC regulations, eligibility, and policies to patients, staff and private health care providers.

• Determine eligibility for PRC and/or alternate resources.

• Issue purchase orders for payment of outside services and monitor throughout the process to ensure accuracy, completeness, and timely payment.

Required Experience:

MINIMUM QUALIFICATIONS:

• High School Diploma or GED certificate/equivalent

• 1 year experience using an Electronic Health Record (EHR)

• 1 year experience in a Medical or Dental setting.

• 6 months hands-on experience using computer-based applications such as Excel and Microsoft Office in a professional manner.

About Us: Chapa-De is a non-profit community outpatient health center with a mission to advance the health and well-being of American Indians and low income individuals living in our communities by providing convenient access to high quality, compassionate care. With clinics located in Auburn, CA and Grass Valley, CA, we have multidisciplinary health care teams that provide a broad spectrum of services.

Chapa-De recognizes that our strength lies in our people. We are committed to the principles of equal employment and complying with all federal, state, and local laws providing equal employment opportunities, and all other employment laws and regulations. It is the intent of Chapa-De to maintain a work environment free of harassment, discrimination, or retaliation. We are dedicated to the fulfillment of this policy in regard to all aspects of employment, including but not limited to recruiting, hiring, placement transfer, training, promotion, rates of pay, and other compensation, termination, and all other terms, conditions, and privileges of employment. Chapa-De provides reasonable accommodation to enable qualified individuals with disabilities to perform the essential functions. Please tell us if you require a reasonable accommodation. Preference in filling vacancies will be given to qualified Indian applicants in accordance with the Indian Preference Act (Title 25, U.S. Code, section 472 & 473).

Keyword: healthcare, insurance, purchase, coordinator, quest

From: Chapa-De