The Southcentral Foundation (SCF) Purchased Referred Care (PRC) Specialist is responsible for efficiently and accurately assisting in executing all aspects of the external referral and emergent authorization process. The PRC Specialist promotes the quality and cost effectiveness of referred medical care by processing claims generated outside of the Tribal Health System. They work in collaboration with medical providers, nursing staff, Family Health Resource (FHR) staff, and Revenue Cycle staff, among others.
This position has two (2) levels designed to provide progressively more responsible and independent work experiences. Progression between job levels is based on the demonstrated ability to successfully handle more progressively responsible assignments.
Minimum Qualifications:

1. Bachelor's Degree in Accounting, Health Care Financial Management, or related field; OR equivalent combination of training, education, and related experience.
2. Three (3) years' experience in medical referrals, or other related medical patient support functions in a clinical setting (such as LPN, CHA II or III, CMA, or CPC)

Additional Qualifications for Purchased Referred Care Specialist II:

1. Two (2) additional years' experience in medical referrals, or other related medical patient support functions in a clinical setting (such as LPN, CHA II or III, CMA, or CPC).

Native Preference:
Under P.L. 93-638, as amended, the company pursues a policy of Native preference in hiring, contracting and training. SCF Human Resources must receive certification before applicants receive preference.
Employee Health Requirements:
Compliance with our Employee Health Procedure is a condition of SCF employment. You are required to agree that you will comply with all job-related employee health screening and immunizations prior to your first day of employment. Jobs designated as a Health Care Personnel (HCP) position, requires that you have documentation that you have completed the following immunizations prior to your first day of employment: MMR (Measles, Mumps and Rubella, Varicella (Chicken Pox), Hepatitis B, Influenza, T-dap (Tetanus - Diphtheria - Pertussis), and COVID-19 vaccination is required.