Paid Healthcare Patient Account Representative

Duties Include

• Responsible for examining all claims for Tribal Health Paid Care (THPC) eligibility and coordinating informational data with Tribal Health Department (THD) Patient Registration and Alternate Health Care Resource (HRC) eligibility programs.
• Generates purchase order (PO) authorizations for approved medical services.
• Maintains interface with Patient Registration and HCR eligibility determinations - ensuring all recipients are properly registered/updated and have been screened for other alternate resources.
• Ensures compliance with established budgets, policies and practices.
• Reports and processes reports as needed during each fiscal year (FY).
• Includes exchanging/sharing of PO's, insurance and pertinent data that is necessary information to complete the task.
• Processes medical claims within a five (5) day goal.
• This includes but is not limited to obligating funds, contacting providers, medical billing departments, doctor off.