Under general supervision of the Purchased Referred Care (PRC) Nurse Manager, the Patient Support Assistant assures PRC fiscal accountability working closely with various departments to ensure coordination between the referring PCP and specialist. Responsible for determining PRC eligibility and coordinating specialty medical service for Dilkon Medical Center (DMC) and Winslow Indian Health Care Center (WIHCC) when WIHCC is unable to meet these healthcare needs. Participates and follows PRC policy and guidelines to meet program goals. Upholds the principles of WIHCC’s Vision, Mission, and Value Statements. Maintains confidentiality of all privileged information at all times.
This list of duties and responsibilities is illustrative only of the tasks performed by this position and is not all-inclusive.
Essential Duties & Responsibilities:
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Maintains regular attendance and punctuality.
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Greets visitors, patients, families, staff and physicians. Uses appropriate, professional courtesy for all telephone interactions.
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Obtains necessary medical information for the RN Case Manager or Clinical Director (CD) to determine medical priority.
- Follows up on appointments, pending referrals and potential AHCCCS.
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Responsible for referral tracking utilizing the PRC referred spreadsheet template.
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Refers patients to Patient Benefits Coordinator (PBC) to apply for alternate resources when they are potentially eligible and documents efforts.
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Maintains familiarity with the contracts or rate quotes of frequently used vendors.
- Receives daily PRC notifications from patients and/or facilities by fax, phone, mail, email, or walk-ins. Date stamps all correspondence on date of receipt.
- Assists in researching in the pertinent electronic record system to identify existing PRC client documentation records, date of service (DOS) per notification and to prevent any duplication. Notes PRC client record number, notifications and other documents for quick referencing and forwards to PRC Associate for processing.
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Assists PRC associates to gather the needed documents within the incumbent’s scope of work to determine and evaluate patient eligibility in accordance with PRC five eligibility criteria: medical priority, residency, notification, alternate resources, and eligibility, and ensuring applicable processes.
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Assists in patient scheduling for elder and disabled persons as needed.
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Provides reports as required by the HSS or PRC Nurse Manager (backlog report).
- Assist in entering notes into RCIS Business Office Comments (BOC) sequencing events of actions taken for each case interaction, i.e. phone calls, providers, purposes, etc.
- Works with PRC Associates to gather data on a periodic basis to ensure proper follow-up which may include contacting vendors via telephone or written correspondence on status of purchase orders.
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Requires completion of tasks or duties assigned by a supervisor.
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Reports any high-risk cases or barriers to care to the RN Case Manager.
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Teaches and trains employees; evaluates program performance, and training needs.
- Provides front office assistant coverage during times of the staff absence.
- Assists with solving computer software and technical issues that may arise.
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Upholds all principles of confidentiality and patient care to the fullest extent.
- Adheres to all WIHCC General Work Rules and Standards of Ethical Conduct.
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Adheres to all professional and ethical behavior standards of the healthcare industry.
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Adheres to WIHCCs Personnel Policies and Procedures, departmental policies, rules, and regulations.
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Interacts in an honest, trustworthy and dependable manner with patients, employees, visitors, and vendors.
- Possesses cultural awareness and sensitivity.
- Maintains compliance with all Human Resources requirements.
- Performs other duties as assigned.
Minimum Qualifications:
High School Diploma or GED. Associates Degree in business related field preferred. One to two years of work experience as a clerk in a structured business environment and ability to provide a high level of customer service through prior supervisory references required. Bilingual skills in English and Navajo language preferred. Must maintain a valid unrestricted and insurable driver’s license. Must successfully pass a background investigation and maintain suitable requirements for a Child Care position. This position is considered as a Child Care position, which requires a satisfactory background check investigation and is subject to the requirements of the Indian Child Protection and Family Violence Prevention Act, as amended (henceforth referred as the ICPFVP Act).
Knowledge, Skills, Ability:
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Knowledge of business English, proper spelling, grammar, punctuation, and basic arithmetic.
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Knowledge of Private Insurance, Medicare and Medicaid payment and reimbursement system.
- Knowledge of the health care delivery system.
- Knowledge of quality customer service.
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Knowledge of strong work ethics in the workplace.
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Knowledge of basic application of confidentiality.
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Knowledge of basic computer skills, e.g. Outlook, Word, Excel, PowerPoint.
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Ability to adapt to different work environments/tasks for floating/coverage purpose
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Ability to handle conflict constructively.
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Ability to gather data, compiles information, and prepares reports.
- Ability to work independently and meet strict time lines.
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Ability to analyze situations and adopt appropriate courses of action.
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Ability to be professional, persuasive and tactful in controversial situations.
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Ability to be dependable in attendance and job performance.
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Ability to meet attendance, overtime (if necessary), and other reliability requirements of the job.
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Ability to accept and learn from feedback.
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Ability to communicate effectively both verbally and in writing.
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Ability to provide exemplary customer service at all times.
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Ability to interact positively with others and possess great interpersonal skills.
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Ability to multitask and perform well under pressure.
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Ability to have self-confidence.
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Ability to be a great team player.
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Ability to accept and learn from supervisor/peer critique.
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Ability to be flexible and adaptable to the changing needs of the organization.
Physical Demands:
While performing the duties of this job, the employee regularly is required to walk; sit; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee frequently is required to stand; climb or balance; and stoop, kneel, crouch, or crawl. The employee frequently is required to taste or smell. The employee must occasionally lift and/or move up to 50 pounds.
Work Environment:
Work is performed in an office setting or outdoor work environment with a moderate noise level. Work environment may involve exposure to physical risks, such as blood borne pathogens and operating dangerous equipment or working with chemicals. Evening and/or weekend work may be required. Extended hours and irregular shifts may be required.
As required by P.L. 93-638, absolute preference will be given to qualified Navajo applicants. If there is no qualified Navajo applicant, preference will be given to qualified American Indian applicants.
