Medical Office Specialist

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.

• 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.

• 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.

• 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.

• 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.

• 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.

• 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.
• 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.
• 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.
• 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.
• 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.
• 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 role answering incoming phone line and scheduling appointments, assisting patients with other items as needed