What are the responsibilities and job description for the Medical Support Assistant position at Akicita Federal, LLC?
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$48,000 - $54,000 a year
Position Overview: The Medical Support Assistant provides comprehensive clerical and administrative support to ensure efficient operations of the Purchase & Referred Care (PRC) program. This position involves assisting in patient eligibility reviews, maintaining accurate documentation, coordinating referrals, and delivering exceptional customer service to patients and stakeholders.
Key Responsibilities:
Patient Eligibility and Documentation:
-Review patient information to determine eligibility for care based on rules, regulations, service delivery areas, tribal membership, and residence.
-Examine alternate resources for patients, including Medicare, Medicaid, Vocational Rehabilitation, Veterans Affairs (VA), private insurance, or other third-party programs.
-Collect and review patient medical information, discharge dates, and referrals to complete medical decision-making and payment determinations.
Communication and Correspondence:
-Mail denial letters to patients, providers, and vendors; maintain denial correspondence and appeals files with all necessary documentation.
-Receive and distribute mail, ensuring timely responses to letters requesting reconsideration for payment.
-Communicate with immediate supervisors about operational challenges or issues.
Coordination with Medical Staff and Providers:
-Collaborate with Service Unit medical staff to ensure proper documentation for patient referrals.
-Conduct follow-ups to confirm referral documentation in automated systems for outside providers/vendors.
-Assist providers with open purchase orders, ensuring prompt payment or cancellation of unused orders.
Clerical and Administrative Support:
-Provide clerical assistance for reporting and monitoring cases.
-Maintain organized program file systems and respond to messages via fax, mail, or other communication promptly.
-Assist with office equipment maintenance and supply inventory management.
-Participate in staff meetings and educational programs, recording meeting notes as needed.
Customer Service:
-Deliver excellent customer service by addressing patient and visitor inquiries and directing them to the appropriate personnel.
-Assist patients with benefit determinations or billing inquiries and explain the Explanation of Benefits (EOB) as needed.
Medical Billing and Coding:
-Use medical coding standards (CPT, HCPCS, ICD-10) and billing methodologies to coordinate benefits.
-Assist in researching referrals and purchase orders to optimize payment cycles.
Compliance and Confidentiality:
-Adhere to the Privacy Act of 1974 and HIPAA regulations to maintain patient confidentiality.
-Follow all Indian Health Service (IHS) Manual guidelines and comply with infection control/safety policies.
-Ensure workstation cleanliness and professional standards of customer service.
Technical Skills:
-Proficient in Microsoft Word, Excel, and Outlook to send paperless bills and communicate with providers.
-Skilled in operating small office equipment, including fax machines, scanners, and copiers.
-Familiarity with medical terminology and billing systems.
Team Collaboration and Strategic Goals:
-Encourage teamwork to achieve PRC’s fiscal year goals and implement effective business practices.
-Participate in strategic planning to continuously improve the PRC payment cycle.
Work Environment:
-Maintain a tidy and organized workstation in compliance with infection control and safety policies.
-Support the PRC program’s mission by providing assistance to patients, team members, communities, outside providers, and clinic staff.
Schedule:
-Monday through Friday, 8:00 AM to 4:30 PM, at least 40 hours per week.
Qualifications:
-Experience with medical billing and coding (CPT, HCPCS, ICD-10) is preferred.
-Strong organizational and communication skills.
-Ability to maintain confidentiality and adhere to HIPAA regulations.
-Proficiency with Microsoft Office Suite.
-Excellent customer service and interpersonal skills.
-The Medical Support Assistant is integral to ensuring the efficient operation of the PRC program while maintaining the highest standards of professionalism and patient confidentiality.
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Salary : $48,000 - $54,000
