General Clerk II
Koniag Government Services
Poplar, MT (In Person)
Full-Time
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Job Description
PRC Eligibility & Program Management:
Assist in determining patient eligibility, scope of benefits, and priority levels for the PRC program Review and analyze patient applications and supporting documentation Apply PRC program guidelines and regulations to make eligibility determinations Ensure compliance with federal Indian Health Service policies and procedures Customer Service & Communications Respond to complex PRC inquiries and requests via telephone, written correspondence, and in-person consultations Provide detailed explanations of PRC benefits, limitations, and procedures to patients and families Serve as a resource for PRC program information and guidance Maintain professional communication with healthcare providers, patients, and familiesCase Management & Documentation:
Maintain comprehensive follow-up systems for Contract Health Services (CHS) patient files Track patient cases from initial application through completion of services Ensure timely processing of referrals and authorizations Monitor case progress and coordinate necessary follow-up actionsFinancial Management & Systems:
Ensure proper allocation of funds for patient referrals, emergency call-ins, and follow-up care Monitor budget constraints and funding availability for PRC services Enter and verify authorizations, payments, cancellations, and supplements in PRC computer systems Maintain accurate financial records and documentation Process payment authorizations and modifications as requiredData Management:
Utilize PRC information systems for data entry, retrieval, and reporting Maintain accurate and up-to-date patient records in electronic systems Generate reports and track program metrics as needed Ensure data integrity and security complianceRequired Qualifications:
Meet minimum qualification requirements as outlined in prime contract Advanced knowledge of PRC program regulations, eligibility criteria, and procedures Strong analytical and problem-solving skills Excellent verbal and written communication skills Proficiency in PRC computer systems and database management Ability to interpret and apply complex program guidelines Strong attention to detail and accuracy in financial transactionsPreferred Qualifications:
Previous experience with Indian Health Service or tribal healthcare systems Knowledge of federal healthcare programs and regulations Experience with contract health services or similar programs Background in healthcare administration or patient servicesAdditional Requirements:
Successful completion of background check Compliance with all IHS policies and procedures Adherence to HIPAA privacy and security requirements Participation in site-specific orientation and competency assessments Computer security training and compliance Ability to handle sensitive financial and medical information Position may involve coverage at multiple BAIHS locations Must be flexible to support continuous service delivery May be required to assist with emergency authorizations outside normal business hoursSecurity Requirement:
Ability to obtain aPublic Trust Working Conditions:
Healthcare office environment with frequent patient interaction Regular use of computer systems and office equipment May require coordination with multiple departments and external providers Fast-paced environment with multiple priorities and deadlines Our Equal Employment Opportunity Policy The company is an equal opportunity employer. The company shall not discriminate against any employee or applicant because of race, color, religion, creed, ethnicity, sex, sexual orientation, gender or gender identity (except where gender is a bona fide occupational qualification), national origin or ancestry, age, disability, citizenship, military/veteran status, marital status, genetic information or any other characteristic protected by applicable federal, state, or local law. We are committed to equal employment opportunity in all decisions related to employment, promotion, wages, benefits, and all other privileges, terms, and conditions of employment. The company is dedicated to seeking all qualified applicants. If you require an accommodation to navigate or apply for a position on our website, please get in touch with Heaven Wood via e-mail at accommodations@koniag-gs.com or by calling 703-488-9377 to request accommodations. Koniag Government Services (KGS) is an Alaska Native Owned corporation supporting the values and traditions of our native communities through an agile employee and corporate culture that delivers Enterprise Solutions, Professional Services and Operational Management to Federal Government Agencies. As a wholly owned subsidiary of Koniag, we apply our proven commercial solutions to a deep knowledge of Defense and Civilian missions to provide forward leaning technical, professional, and operational solutions. KGS enables successful mission outcomes for our customers through solution-oriented business partnerships and a commitment to exceptional service delivery. We ensure long-term success with a continuous improvement approach while balancing the collective interests of our customers, employees, and native communities. For more information, please visit www.koniag-gs.com . Equal Opportunity Employer/Veterans/Disabled. Shareholder Preference in accordance with Public Law 88-352 group id: 10201473 N Name Hidden Recruiter Apply nowSimilar remote jobs
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