Medical Office Specialist II - Call Center PERKINS ROAD

JOB PURPOSE OR MISSION: Performs multiple administrative and clerical duties within a clinic setting.
PERFORMANCE CRITERIA CRITERIA A: Everyday Excellence Values - Employee demonstrates Everyday Excellence values in the day-to-day performance of their job.
PERFORMANCE STANDARDS: • Demonstrates courtesy and caring to each other, patients and their families, physicians, and the community.
• Takes initiative in living our Everyday Excellence values and vital signs.
• Takes initiative in identifying customer needs before the customer asks.
• Participates in teamwork willingly and with enthusiasm.
• Demonstrates respect for the dignity and privacy needs of customers through personal action and attention to the environment of care.
• Keeps customers informed, answers customer questions and anticipates information needs of customers.
CRITERIA B: Corporate Compliance - Employee demonstrates commitment to the Code of Conduct, Conflict of Interest Guidelines, and the GHS Corporate Compliance Guidelines.
PERFORMANCE STANDARDS • Practices diligence in fulfilling the regulatory and legal requirements of the position and department.
• Maintains accurate and reliable patient/organizational records.
• Maintains professional relationships with appropriate officials; communicates honesty and completely; behaves in a fair and nondiscriminatory manner in all professional contacts.
CRITERIA C: Personal Achievement - Employee demonstrates initiative in achieving work goals and meeting personal objectives.
PERFORMANCE STANDARDS • Uses accepted procedures and practices to complete assignments.
Uses creative and proactive solutions to achieve objectives even when workload and demands are high.
• Adheres to high moral principles of honesty, loyalty, sincerity, and fairness.
• Upholds the ethical standards of the organization.
CRITERIA D: Performance Improvement - Employee actively participates in Performance Improvement activities and incorporates quality improvement standards in his/her job performance.
PERFORMANCE STANDARDS • Optimizes talents, skills, and abilities in achieving excellence in meeting and exceeding customer expectations.
• Initiates or redesigns to continuously improve work processes.
• Contributes ideas and suggestions to improve approaches to work processes.
• Willingly participates in organization and/or department quality initiatives.
CRITERIA E: Cost Management - Employee demonstrates effective cost management practices.
PERFORMANCE STANDARDS • Effectively manages time and resources • Makes conscious effort to effectively utilize the resources of the organization — material, human, and financial.
• Consistently looks for and uses resource saving processes.
CRITERIA F: Patient & Employee Safety - Employee actively participates in and demonstrates effective patient and employee safety practices.
PERFORMANCE STANDARDS • Employee effectively communicates, demonstrates, coordinates and emphasizes patient and employee safety.
• Employee proactively reports errors, potential errors, injuries or potential injuries.
• Employee demonstrates departmental specific patient and employee safety standards at all times.
• Employee demonstrates the use of proper safety techniques, equipment and devices and follows safety policies, procedures and plans.
JOB FUNCTIONS ESSENTIAL JOB FUNCTIONS include, but are not limited to: 1.
Answers telephone, greets visitors and schedules appointments.
PERFORMANCE STANDARDS: • Courteously and professionally greets guests/answers phone calls and handles appropriately according to clinic protocols.
• Maintains master scheduling program for all areas and makes appointment schedules for all patients, via computer system according to established procedures.
• Coordinates transportation needs of patients as needed.
• Coordinates insurance coverage with patients, insurance company, and Business Office as indicated.
• Communicates special patient needs to appropriate staff.
2.
Enters patient charges, completes chart maintenance and provides a variety of clerical support functions.
PERFORMANCE STANDARDS: • Enters charges accurately on the same day it is incurred.
• Coordinates charge data functions according to established procedures Types and proofs a variety of material (e.
g.
, letters, forms, reports, etc.
) from rough draft and corrected copies.
• Maintains accurate and current files of all patient records, correspondence, reports, and information, as required.
• Forwards completed discharged charts to Medical Records according to established procedures.
• Prepares patient folders and files patient information appropriately, copies charts as approved by Medical Records, faxes and files a variety of materials.
• Mails patient evaluations, progress notes, prescriptions, etc.
, and follows-up on all correspondence within defined time lines.
3.
Performs billing functions to ensure proper billing and collections.
PERFORMANCE STANDARDS: • Identifies and records required billing information according to insurance carrier requirements with 100% accuracy.
• Completes billing information accurately.
• Processes claims electronically with 100% accuracy and mail claims to insurance carriers daily.
• Enters documentation and adjustments through computer system to maintain a correct account balance.
• Updates system information daily according to correspondence received and processed.
• Documents any changes on a daily basis and submits information to appropriate personnel.
• Seeks clear directions to resolve issues and bring problems to a proper resolution.
4.
Reviews and identifies charge discrepancies and completes all requests for rebilling from inter-department personnel.
PERFORMANCE STANDARDS: • Reviews charge summaries on each patient bill that is produced and identifies discrepancies with 100% accuracy.
• Audits requests for accurate information.
• Completes rebilling within 10 days according to established rebilling procedures.
• Manually documents rebilling log upon completion with 100% accuracy.
5.
Prepares daily production reports, maintains required records, reports, and files while evaluating account information.
PERFORMANCE STANDARDS: • Monitors number of accounts and outstanding balances within three days of receiving report.
• Consistently applies appropriate procedures to prevent accounts from becoming delinquent or remaining unbilled.
• Initiates appropriate follow-up.
6.
Performs all other duties as assigned.
SPECIFIC EXPERIENCE REQUIREMENTS Sufficient prior experience with billing, scheduling and general office responsibilities in a clinic setting.
SPECIFIC EDUCATIONAL REQUIREMENTS High School Diploma preferred, post high school vocational/specialized training encouraged.
SPECIAL SKILL, LICENSE AND KNOWLEDGE REQUIREMENTS Minimum typing skills of 45 wpm, ten key by touch, data entry skills.
HIPAA REQUIREMENTS: Maintains knowledge of and adherence to all applicable HIPAA regulations appropriate to Job Position.
SAFETY REQUIREMENTS: Maintains knowledge of and adherence to all applicable safety practices appropriate to Job Position including but not limited to: incident reporting, handling wastes, sharps and linens, PPE, exposure control plan, hand washing, and environmental round to ensure safety,