PRC Claims Analyst, Purchased/Referred Care

The Mohegan Tribe of Indians Of Connecticut; Mohegan (CT); On-site; USD 52,000 - 75,000; Full time

Benefits offered by this job

Private parking

Job summary

The Mohegan Tribe of Indians Of Connecticut is seeking a PRC Claims Analyst for the Purchased/Referred Care program in Uncasville, CT. This full-time role involves reviewing, evaluating and processing requests for assistance, with emphasis on accuracy and confidentiality.

The ideal candidate has a background in medical coding or billing, knowledge of ICD-10/CPT, and experience with EHR or electronic billing systems. Strong organizational skills and familiarity with payer policies are required.

Qualifications

• Three (3) years' experience in medical coding or billing.
• Two (2) years' experience with either Electronic Health Record (EHR) or electronic billing/system.
• Knowledge of ICD-10 and CPT coding.
• Certified Professional Coder (CPC) or CPB or both.

Responsibilities

• Review, evaluate and process requests for assistance in the Tribal Purchased/Referred Care program.
• Maintain confidentiality and handle sensitive information.
• Coordinate with payers and internal teams as needed.

Skills

IHS PRC programs

Medical terminology

ICD-10 & CPT coding

Payer reimbursement policies

Word & Excel

EHR systems

Organizational skills

Confidentiality

Education

High school diploma

Medical coding or billing experience

EHR/electronic billing experience

CPC or CPB certification

Customer-facing or data-entry experience

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

PRC Claims Analyst, Purchased/Referred Care

Full-Time Regular H.F.T. Uncasville, CT, US

Summary of Job Description:

Incumbent in this position reviews, evaluates and processes requests for assistance made to the Tribal Purchased/Referred Care program.

• Knowledge of IHS Purchased Referred Care Programs & Services or ability to learn
• Knowledge of medical terminology, ICD-10 and CPT coding
• Knowledge of Medicare, Medicaid and other payers' reimbursement policies and procedures
• Intermediate Word and Excel skills (skill level determined by testing)
• Strong knowledge of claims adjudication or Electronic Health Record (EHR) systems
• Strong organizational skills
• Ability to maintain strict confidentiality

Education, Experience and Training:

• High school diploma
• Three (3) years' experience in medical coding or billing
• Two (2) years' experience with either Electronic Health Record (EHR) or electronic billing/payment system

~OR~

• High school diploma
• Certified Professional Coder (CPC) or Certified Professional Biller (CPB) or both
• One (1) year of experience in a customer-facing or data-entry role in any medical office setting

The Mohegan Tribal Government is committed to Native American Preference and is an Equal Opportunity Employer.