Purchased Referred Care Coordinator

1 week ago


Rapid City, South Dakota, United States Great Plains Tribal Leaders Health Board Inc Full time
Job Description: Medical Claims Analyst

The successful candidate will be responsible for analyzing and re pricing outside vendor claims according to federal guidelines and OHC PRC policies. This role requires strong analytical and organizational skills, as well as excellent communication and interpersonal skills.

Key Responsibilities:
  • Review and analyze UB-04 and CMS 1500 claim forms for accuracy and completeness.
  • Re-price clean claims using appropriate software applications.
  • Communicate effectively with vendors and patients regarding claims and repricing information.
  • Maintain accurate records and provide reports on claim status and outcomes.


Requirements:
  • Associate degree or equivalent in a related field, or 3 years of relevant administrative office support experience.
  • Prior experience in purchase referred care or medical coding is preferred.
  • Strong analytical and problem-solving skills.
  • Excellent communication and interpersonal skills.


Benefits:
  • Competitive salary range: $40,000 - $60,000 per year.
  • Benefits package including health, dental, and vision insurance.
  • Retirement plan with employer match.
  • Professional development opportunities.


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