
Job Description
This position is located in the Purchased/Referred Care at the Blackfeet Service Unit in Browning Montana. The purpose of the position is to administer the provision of Purchased/Referred Care in Compliance with regulatory requirements set for in the 42 CFR, subpart 136, to determine patient's eligibility, defining and interpreting PRC regulations and guidelines and maintaining records.
Duties Receives notification and referrals for non-IHS and IHS referred care through hard copy or the automated referred care system. Enters or edits all referrals. Ensures accurate data entry in order to retrieve meaningful reports. Ensures that PRC funds are available prior to issuance of obligating documents on behalf of the government. Provides forecasting of weekly document control register balances after each week's obligations have been completed to ensure funds are expended in accordance within spending plans. Maintains complete fund control records for health services funds allotted. Ensures the presence of accurate information, monitors activities and records pertaining to the fiscal management of funds. Issues correspondence to patients, health care providers and other agencies regarding eligibility, IHS policy and regulations, including letters of denial of payment where the requirements of the IHS Program are not met. Tracks all referrals to non-IHS facilities to include those referrals to other IHS facilities to support the Case Management activities and continuity of care efforts. Participates in the weekly Case Management meetings, takes minutes and prepares the minutes for record and reporting purpose. Researches and follow up with non-IHS facilities on weekly basis for current medical status and costs to determine whether the case will be a Catastrophic Health Emergency Fund (CHEF) case. Performs other duties as assigned. Some duties not specifically described or included in the Position Description (PD) may be assigned from time to time to meet the departments or facility's objectives and obligations. Salary- $44,959 - $71,932/year