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 honestly 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:
- Effectively communicates, demonstrates, coordinates and emphasizes patient and employee safety.
- Proactively reports errors, potential errors, injuries or potential injuries.
- Demonstrates departmental specific patient and employee safety standards at all times.
- 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.
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