PRC Claims Analyst - Medical Billing & EHR Specialist

United South and Eastern Tribes Inc.; Connecticut; Hybrid; USD 48,000 - 72,000; Full time

Job summary

United South and Eastern Tribes Inc. is seeking a PRC Claims Analyst for the Purchased/Referred Care program in Uncasville, CT. The role focuses on reviewing and processing requests for assistance, guided by IHS PRC protocols and payer policies.

The ideal candidate will have knowledge of ICD-10 and CPT coding, Medicare/Medicaid rules, strong Word/Excel skills, and a commitment to confidentiality and organization.

Qualifications

• High school diploma required.
• 3 years’ experience in medical coding or billing.
• 2 years’ experience with either EHR or electronic billing system.
• CPC and/or CPB certification preferred.
• 1 year of customer-facing or data-entry experience in a medical office.

Responsibilities

• Review, evaluate and process requests for assistance to the PRC program.
• Apply knowledge of PRC guidelines, ICD-10/CPT coding and payer policies.
• Maintain confidentiality and accurate records; work with EHR systems as needed.

Skills

IHS PRC knowledge

ICD-10 & CPT coding

Medicare/Medicaid policies

Word & Excel

Claims adjudication or EHR

Confidentiality

Organizational skills

Education

High school diploma

CPC

CPB

Tools

Microsoft Word

Microsoft Excel

EHR System

Job description

United South and Eastern Tribes Inc. is seeking a PRC Claims Analyst for the Purchased/Referred Care program in Uncasville, CT. The role focuses on reviewing and processing requests for assistance, guided by IHS PRC protocols and payer policies.

The ideal candidate will have knowledge of ICD-10 and CPT coding, Medicare/Medicaid rules, strong Word/Excel skills, and a commitment to confidentiality and organization.