Purchase and Referred Care Specialist

SUMMARY: The primary purpose of this position is to provide technical assistance to the Health Center Director in carrying out the Purchase and Referred Care Program. To supervise and participate in the expenditure of Purchase and Referred Care funds.

ESSENTIAL DUTIES and/or RESPONSIBILITIES include the following:

• Initiates and prepares medical authorizations to include hospitalizations and medical fees.
• Maintains complete documentation control registers for Health Service funds allotted which requires the accurate accountability of funds and comprehensive knowledge of fiscal coding procedures (if applicable).
• Contacts State agencies to determine medical eligibility within the jurisdiction of the Health Center.
• Functions in a liaison capacity to vendors and recipients of Purchase and Referred Care Services. Develops and negotiates vendor contract at least annually.
• Provides training and orientation to Health service vendors, recipients, and Health Center personnel to insure a thorough understanding of the program policies and procedures.
• Conducts on-site interviews to establish eligibility of patients for direct and contract services.
• Maintains direct contact with the Medical Staff, Medical Records, Health vendors, hospitals, and other physicians and patients.
• Observes confidentiality in all phases of work in this department.
• Prepares and distributes all Purchase and Referred Care Service authorizations, including both hospital and medical fees for eligible persons.
• Checks and audits Purchase and Referred Care Services invoices; post all expenditures to each account level.
• Prepares requisitions/purchase orders for Comptroller from complete authorizations for payment. Receives from Comptroller; sends checks for all vendors for proper payment.
• Conducts weekly PRC Committee Meetings, with full report to all Committee Members: PRC Committee consist of Medical Staff, Executive Director, Social Service, Medical Records, Administrative Officer, and Clinic Nurse.
• Financial reports of PRC funds are to be reported weekly to the Medical Staff and Executive Director.
• Maintains unmet surgical needs register and catastrophic costs and submits to the Aberdeen Area Contract Health Office as required.
• Is accountable for the maintenance and control of PRC funds for medical services. Compiles statistical and fiscal data necessary to determine funds required to meet the need of the PRC program for the CTCHEC.
• Assists in implementing and directing the patient data base information system; which includes conducting patient interviews to update information on demographic and third party resource data, recording the information and submitting to the Business Office.
• Shall annually prepare and periodically update a PRC budget based on allocations provided by the Area Office. Also, prepare documented evidence and justification for requests for additional PRC funds.
• Makes all non-urgent/emergent medical referral appointments.

QUALIFICATION REQUIREMENTS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION AND/OR EXPERIENCE:

• An Associates Degree in Business or related field with at least four (4) years experience in a business environment.
• Minimum qualifications are a High School Diploma or G.E.D. with formal training in general bookkeeping, accounting and typing.
• Experience in a similar field or no less than two (2) years required.

Must pass background check, physical, and pre-employment drug screen.

Salary : $25 - $30