Medical Office Specialist- Call Center

Company: Baton Rouge General Medical Center
Location: Baton Rouge
Posted on: January 25, 2023

Job Description:

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,
Medical Office Specialist

Keywords: Baton Rouge General Medical Center, Baton Rouge , Medical Office Specialist- Call Center, Healthcare , Baton Rouge, Louisiana