Job Description
Job Description
Summary
The Administrative Floater will be trained and provide support for all administrative roles within the Health Center to meet business needs.
These roles include duties related to the following departments : patient services representative (Medical, Dental, Behavioral Health and Substance Abuse), referrals, medical records, outreach and enrollment, and administrative assistant.
Essential Functions
- Must become familiar with the policies and procedures of our facilities, including but not limited to : health center, Village-based, and community resources available.
- Uses customer service skills to greet patients, clients, and visitors entering the clinic following all organizational customer service guidelines.
- Maintain effective communication and working relationships with the patients and other employees by collaborating with other internal and external departments to provide assistance, guidance and direction to visitors and patients.
- Completes patient registration by verifying patient’s demographic and personal information and enters them in the appropriate EHR program at each visit, obtains forms for billing, and sliding scale program, with assessment and collection of payment as necessary;
assist patients with completion of forms if applicable.
- Performs check in processes of patient appointments following the set procedures and protocols for all departments of the Village Health Center in the electronic health record.
- Verifies insurance benefits and eligibility by using insurance portals or telephone to assure accurate billable services.
- Schedules, reschedules, and / or cancels patient appointments at patient or provider request.
- Accurate documentation and routing of messages.
- Reviews the electronic health record to identify and process referrals submitted by clinicians.
- Utilizes customer service skills to coordinate, process, and document referral between clinician, referral source, insurance and patient to assure accountability.
- Follows-up on missing documentation to obtain authorization when appropriate; schedules appointment for specialty care, special studies, Durable Medical Equipment (DME) or other ancillary services as requested by the care provider to ensure proper access to care.
- Keeps abreast of payer contracts in order to refer patients to providers within their network.
- Ensures the referral loop is closed by tracking, monitoring and documenting referral from initiation to completion in the electronic health record utilizing the corresponding work queues.
- Tracks and follows up on the status of all incoming and outgoing Health information documents to assure timely communication of patient records and close referral loops.
- Index and associate each scanned document with the correct patient’s record, the appropriate documents, assign the appropriate document-named nomenclature, and electronically sign on chart scanned documents
- Responds to and processes requests / releases including but not limited to request of information, subpoenas, court orders, etc.
in a timely manner adhering to legal time allotted per hospital and HIPAA policies and procedures.
- Assists with ordering mail pickup and delivery, internal and external collaboration for equipment and supply deliveries.
- Determines an individual's eligibility for appropriate programs with a focus on health insurance.
- Provide enrollment assistance (including but not limited to completing coverage applications and renewals, gathering required documentation and troubleshooting the enrollment process) for uninsured adults to access subsidized, low-cost and free health insurance programs through Medi-Cal and other managed care plans to increase patient access to health care.
- Uses strong customer service skills to perform outreach, meets and / or distributes materials to patients, community members, partner organizations and businesses to build positive working relationships and provide patients coverage option awareness.
- Determines an individual's eligibility for appropriate programs with a focus on health insurance for billing reimbursement and assess their income and educates them on how to access and utilize those services including food stamps, housing, and transportation.
- On time completion of assigned training and policies.
- Performs other duties as assigned.
Qualifications
- Associate degree; Medical or Dental office administration Vocational certificate or 3+ years equivalent experience.
- Bachelor’s Degree in healthcare or social services preferred.
- Bilingual (Spanish / English) preferred.
- 2+ years’ experience using a medical and / or dental electronic health records system.
- EPIC experience preferred.
- Knowledge of medical terminology.
- 1 year of experience verifying insurance / program eligibility and benefits required.
- Knowledge of Medi-Cal, Medicare, managed care plans, third party rules and regulations and insurance guidelines preferred.
- Medical procedural coding, CPT and ICD-10 codes. Preferred.
- Intermediate knowledge of insurance providers, their portals and their expectations for referral authorization approval.
- Knowledge of and compliance with HIPAA privacy laws
- Strong organizational skills and attention to detail, capable of multitasking and managing multiple patient cases efficiently.
- Ability to interface with all levels of personnel in a professional manner.
- Participate in an annual Tuberculosis screening and / or other screenings when necessary. Reasonable accommodation may be granted where appropriate.
- Basic user of MS Office.
14 days ago