Medical Office Specialist - BRFMC

JOB PURPOSE OR MISSION: Performs 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 mails 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 requests for rebilling from inter-department personnel.

PERFORMANCE STANDARDS: • Reviews charge summaries on each patient bill that is produced and identifies discrepancies. • 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,

Full-Time