Clerical Support Team Member

Job ID: 21-12296 Description:
Job Title: Clerical Support Team Member


Duties: Supports Regulatory and Compliance and Vendor Specialists in preparing and compiling documents requested for regulatory/compliance filings, external audit preparation, special projects, and any other required to support work as assigned. Supports Coding Team with Claims and Account edits, and makes corrections not requiring Coder expertise. Routes complex edits to Coders as necessary.

Assignment Specific Responsibilities

• Performs large copy and document production efforts for regulatory/compliance filings and vendor audits requested by third parties, internal /external entities, and intradepartmental sources as directed

• Supports preparation of special reports to document billing and follow-up services (e.g., pulling records, documents from systems, document imaging status, etc.)

• Acts as point person for Central Business Office or Physician requests for diagnosis changes and manages routing and resolution

• Assists in researching reason for Coding/Billing delays of unbilled accounts by identifying necessary documentation from coding staff and routing as necessary, following up to make sure account is routed to coder when documentation is available, and calling or contacting physician offices regarding pending queries

• Assists in resolution of documentation deficiencies or charge errors affecting Coding operations by identifying necessary documentation from coding staff and routing as necessary, contacting ancillary departments to resolve charge errors, and/or adding missing charges and correcting registration errors

• Assists in management and routing of account combinations for billing purposes and Coding claim edits by managing requests in the Epic edit queue and combine account queue and routing to appropriate coding staff for correction

• Works with Patient Access to resolve registration issues including: correcting registration types, cancelled accounts, and duplicate accounts

• Acts as point person for Central Business Office or Physician requests for diagnosis changes, and manages routing and resolution

• Assists in managing and follow up of account issues for Vendor Coding staff pended accounts by contract coders

• Provides input to team regarding issues affecting coding operations

• Assists with Coder productivity and annual requirements tracking by monitoring and providing biweekly coder productivity reports to the Coding Operations Team Leads

• Assists with correction of Office of Statewide Health Planning and Development edits

• In initial year, participates in cross-training and job enlargement opportunities for Major job responsibilities. Works with direct supervisor to identify minor set of responsibilities to develop and perform in support of peaks, valleys and cycles across the Shared Services Organization and individual career growth opportunities. Performs both Major and Minor responsibilities after initial year

Experience

• Demonstrated experience and a proven track record in Clerical/Coding Support in a facility of significant size and complexity, hospital business operations, information systems, and patient accounting applications, as typically acquired in 0-2 years of experience preferred

• Experience executing Clerical/Coding Support standards, processes, policies, procedures and service level agreements preferred

• Experience in complex regional/ shared service environment with multiple/ matrix reporting relationships preferred Knowledge

• General knowledge of various insurance documentation requirements, the patient accounting system, and various data entry codes to ensure proper service documentation and billing of the patient's account preferred

• Knowledge of insurance and governmental programs, regulations and billing processes (e.g., Medicare, MediCal, Medicaid, Social Security Disability, Champus, Supplemental Security Income Disability, etc.), commercial third party payers, managed care contracts and coordination of benefits helpful

• Familiarity with medical terminology and the medical record coding process helpful

• General knowledge of Revenue Cycle applications, including Hospital Patient Accounting and Electronic Health Record systems desired

• General knowledge/ awareness of all areas related to Clerical/Coding Support and how they interrelate

• Knowledge of principles, methods, and techniques related to compliant healthcare billing/collections helpful

• Familiarity with Clerical/Coding Support management functions in acute and non-acute settings

• Knowledge of Patient Management information system applications, preferably EPIC

Skills

• Ability to comprehend and retain information that can be applied to work procedures to achieve appropriate service delivery

• Data entry skills (minimum 50-60 accurate keystrokes per minute)

• Requires strong accuracy, attentiveness to detail, and time management skills

• Aptitude to conceptualize, plan, and implement stated goals and objectives

• Ability to manage own schedule and responsibilities. Must have the initiative to work effectively without constant supervision and direction, meeting all deadlines

• Ability to develop effective working relationships/ networks within and outside the organization

• Excellent ability to communicate ideas both verbally and in writing to interact with others using on-on-one contact and group discussions

• Ability to recognize the appropriate style, level of detail, and message for the audience

• Ability to use the spreadsheet and word processing applications, preferably Microsoft Suite

• Ability to learn new applications/software systems effectively and efficiently

• Ability to comply with policies and procedures

• Requires the ability to work with and maintain confidential information

Keywords:

Education: Required • High School Diploma Desired - AA/AS in Account or Business Skills and Experience: