CTHCA PRC Referral Clerk (TM48049)

Closing Date: July 9, 2026

Position: CTHCA PRC Referral Clerk

Salary: $21.35 - $26.00

Reports to: Revenue Cycle Director

Location: Nespelem

SUMMARY:

The Referral Clerk provides administrative support to the Purchased/Referred Care (PRC) program by

processing and tracking patient referrals to external healthcare providers. This role involves coordinating

with patients, providers, and insurers to ensure appropriate documentation, eligibility, and follow-up for

referred care services. The Referral Clerk ensures compliance with PRC policies, Indian Health Service

(IHS) regulations, and tribal healthcare standards. The Referral Clerk position is distinguished by its focus on managing external healthcare referrals within the PRC system. It requires knowledge of PRC regulations, HIPAA compliance, and medical terminology. This role is critical for ensuring timely and efficient coordination of off-site patient care services.

ESSENTIAL FUNCTIONS:

• Receive and review referral requests for completeness and eligibility.
• Enter referral data into the Electronic Health Record (EHR) and PRC tracking systems.
• Coordinate appointments with external providers, ensuring patient notification.
• Verify patient eligibility for PRC services and confirm insurance status.
• Maintain organized records of all referrals and authorizations.
• Follow up with providers and patients regarding referral status.
• Collaborate with PRC and billing staff to ensure accurate documentation and payment
• processing.
• Adhere to confidentiality standards and HIPAA regulations.
• Support quality improvement efforts and reporting as needed.
• Work is typically performed in a clinical office environment.
• May involve interaction with patients who are distressed or frustrated.
• Occasional travel for training or meetings may be required.
• Performs other duties as assigned

KNOWLEDGE, SKILLS, AND ABILITIES:

• High School Diploma or GED required.
• Two (2) years of experience in a healthcare office, referral coordination, or medical records preferred.
• Experience with PRC or IHS systems highly desirable.
• Valid driver’s license and ability to pass a background check.
• HIPAA certification or willingness to obtain.
• CPR certification preferred.
• Knowledge of PRC policies, IHS referral protocols, and tribal health system practices.

• Familiarity with medical terminology, billing codes, and insurance verification.
• Proficiency in Microsoft Office and EHR systems.
• Strong organizational skills and attention to detail.
• Effective communication and customer service skills.
• Ability to manage multiple referrals and follow up in a timely manner.
• Ability to maintain confidentiality and adhere to HIPAA regulations.
• Ability to communicate effectively with patients, staff, and external providers.
• Ability to work both independently and as part of a team.
• Ability to adapt to changing procedures and program requirements.
• Valid driver’s license and ability to pass a background check.
• HIPAA certification or willingness to obtain.
• CPR certification preferred.
• Must adhere to infection control and safety protocols.
• Ability to travel occasionally for training or program coordination.

PHYSICAL REQUIREMENTS:

• Ability to sit and stand for long periods of time
• Manual and finger dexterity to complete duties
• Ability to frequently bend, stoop, and reach
• Ability to push and pull frequently
• Ability to comprehend complex issues
• Occasional lifting of files, records, or office supplies up to 25 pounds.
• Requires hearing and speaking to exchange information and read documents.
• Sufficient visual acuity to write, recognize printed materials, computer screen, and notice non-verbal behavior
• Speech and hearing ability to project voice to small and large audiences, carry on telephone conversations, hear and grasp verbal communications and equipment prompts
• Ability to drive in adverse weather conditions

Note: Pursuant to Tribal Policy, if this position is safety sensitive it is subject to pre-employment drug testing. In addition, this position is subject to reasonable suspicion and post-accident drug testing.

 TRIBAL MEMBER AND INDIAN PREFERENCE WILL APPLY; PREFERENCE WILL ALSO BE GIVEN TO HONORABLY DISCHARGED VETERANS WHO ARE MINIMALLY QUALIFIED.

 If required of this position, you must possess and maintain a valid Washington State driver’s license and be eligible for the Tribes’ Vehicle Insurance.  In addition, this position may be subject to pre-employment background clearances.  If applicable, these clearances must be maintained throughout employment.

INFORMATION: Terri Mail, HR Generalist, Colville Tribal Health Care Authority, Human Resources Office, P.O. Box 150, Nespelem, WA 99155, (509) 846.3774. terri.mail.ohc@colvilletribes.com

Salary : $21 - $26