Patient Referred Care Assistant

Prepared on May 20, 2026

Department	Wellness Center
Reports To	Health Director
Type of Employment	Full-Time
Work Hours	40 Hour Work Week
FLSA Status	Non-Exempt
Salary	$19.00-$24.00 per hour DOQ

Summary

The PRC Assistant assists the PRC Specialist with patient registration for Purchased/Referred Care and Direct Care, manages eligibility paperwork, assists with Medicaid and other resource applications, maintains files in order, scans documents, and supports claims processing. This role ensures PRC records are accurate, patient files are organized, documentation stays confidential, and the PRC program runs smoothly.

Job Description

Essential Duties and Responsibilities

Include the following, other duties may be assigned.

Assists with patient registration for Direct Care and Purchased/Referred Care services. Registers Native American patients for Direct Care, Purchased/Referred Care, and/or Contract Health Services.
Assists with determining patient eligibility by gathering required documents and preparing information for PRC review.
Conducts or assists with patient interviews to establish eligibility and screen for alternate resources.
Assist patients with completing PRC, Direct Care, Medicaid, Washington Healthplanfinder, renewal, and alternate resource applications.
Supports Medicaid-related services by helping patients understand eligibility requirements, gather verification documents, complete applications, and maintain coverage when Medicaid is an available alternate resource.
Develops a working knowledge of Medicaid, Medicare, private insurance, Washington Healthplanfinder, and other coverage options that may be considered alternate resources.
Assists as appropriate with Washington Healthplanfinder access, including Tribal Assister or enhanced user access through HCA, as assigned.
Enters, updates, and verifies patient information in RPMS, EPIC, and other approved electronic health record or program systems within authorized access.
Completes, organizes, labels, scans, and maintains PRC and Direct Care patient files to ensure information is accurate, current, and filed appropriately.
Assists with scanning and digital file maintenance projects, including Direct Care files for individuals who are not current patients, deceased patient files, and current patient records.
Help develop and maintain improved PRC forms, checklists, labels, filing systems, and workflow tools.
Maintains appropriate PRC files and performs office clerical support work required for PRC operations.
Assists with Phase Two claims-processing support after appropriate training, including matching new bills to existing purchase orders, preparing vouchers, researching other insurance billing, notifying providers of alternate resources, assisting with denials, copying checks, preparing checks for mailing, posting payments in RPMS, and maintaining patient and vendor files.
Assists with PRC correspondence and documentation, including denial letters for non-covered services, over-age letters, open purchase order letters, notices, forms, and other program correspondence.
Assists with the Car Seat Program for PRC and Direct Care patients, including maintaining required certification, educating patients on correct car seat installation, determining the appropriate seat, issuing seats within program guidelines, and ordering seats within the assigned budget.
Maintains strict confidentiality and follows HIPAA, Tribal confidentiality, patient privacy, and Wellness Center policy requirements when handling patient information, eligibility documents, Medicaid information, claims, correspondence, files, and electronic systems.
Provides limited PRC-related clerical and operational support as needed, including making copies, preparing packets, scanning documents, checking the front-entry camera, assisting with meeting setup, and maintaining organized PRC work areas.
Maintains current, active, CPR certification. Valid, unrestricted Washington State licensure
Participate in the Tribe’s quality improvement planning activities as necessary.
Work closely with Wellness Center staff, tribal members, outside vendors, and Tribal departments as necessary.
Performs any additional reasonable roles and responsibilities as determined necessary by the Health Director or Assistant Health Director.

Safety:

Demonstrates knowledge of CDC, Dept. of Health, OSHA standard as it applies to the clinic environment.
Adheres to universal precautions.

The above statements are intended to describe the general nature and level of work performed by a person in this position. They are not to be construed as an exhaustive list of all duties that may be performed in such a position.

Supervisory Requirements

This position has no supervisory responsibilities.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Experience and Eduction

High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience.

Skills

LANGUAGE SKILLS: Ability to read and comprehend instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.

MATHEMATICAL SKILLS: Basic math

REASONING ABILITY: Ability to apply common sense understanding to carry out detailed written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.

Essential Competencies

Patient Service – Manages difficult or emotional patient situations; responds promptly to patient needs; responds to requests for service and assistance; meets commitments.

Interpersonal Skills – Focuses on solving conflict; maintains confidentiality; listens to others without interrupting; keeps emotions under control.

Oral Communication – Speaks clearly and persuasively in positive or negative situations; listens and obtains clarification; responds well to questions.

Written Communication – Writes clearly and informatively; edits work for spelling and grammar; varies writing style to meet needs; presents numerical data effectively; able to read and interpret written information.

Ethics – Treats people with respect; works with integrity and ethically; upholds organizational values.

Professionalism – Approaches others in a tactful manner; reacts well under pressure; treats others with respect and consideration regardless of their status or position.

Safety and Security – Observes safety and security procedures; reports potentially unsafe conditions; uses equipment and materials properly.

Dependability – Follows instructions, responds to management direction; takes responsibility for own actions; commits to long hours of work when necessary.

Attendance and Punctuality – Is consistently at work and on time; ensures work responsibilities are covered when absent; arrives at meetings and appointments on time.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Common office environment.

At-Will Employment

This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employee(s) will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. The employment relationship with Shoalwater Bay Indian Tribe is voluntary; there is no specified length of employment. Accordingly, either the Shoalwater Bay Indian Tribe or the employee may terminate the employment relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.

This document does not create an employment contract, implied or otherwise.

INDIAN PREFERENCE

Indian preference will be exercised in the hiring of this position in accordance with Shoalwater Bay Indian Tribe’s policy 181 within the Tribes Employee Handbook.

Benefits

After 60 days of employment

Medical
Vision
Dental
Life and Accidental Death & Dismemberment coverage
Short term disability
Long term disability
Disability resources

After 90 days of employment use of

Annual Leave accrual
Sick Leave accrual
Bereavement Leave
Military Leave
Jury Duty Leave
Paid Holidays

After 1 year of employment

401K contribution

Work Location	Work on Location Premises 2373 Tokeland Rd Tokeland, WA 98590
Job Posting Valid Through	Valid until filled
Position Start Date	Immediately