Medical Office Clerks

Medical Office Clerks ERP International, LLC is seeking Medical Office Clerks for full-time positions supporting Naval Medical Center San Diego and surrounding clinics. Position Locations: DBC EASTLAKE Primary Care DBC MIRAMAR Primary Care DBC NASNI Primary Care DBC NAVBASE Primary Care DBC PT LOMA Primary Care DBC NMCSD Radiology DCSS NMCSD Breast Health Clinic Core Duties: Greets patients/visitors at a clinic front desk. Checks in patients for patient encounter. Answers main office phone line. Schedules medical appointments and determines patient eligibility for services as needed. Obtains documentation as requested by healthcare providers. Performs other administrative and clerical duties in support of medical care and operational support. Creates appointment schedules and templates in patient appointment computer system. Conducts end-of-day process at close of business and resolves any delinquent or pending appointments in computer system. Provides customer service by telephone and/or in person. Assists patients and/or family members with contacting social services, chaplains, health benefits advisors, or patient administration/admission personnel. Creates preadmission charts and completes the process in the electronic reporting systems. Corrects admission errors. Prepares and files weekly and monthly reports based on input from logs and files. Operates facsimile machine and photocopies records. Enters doctor's orders for lab and x-ray tests as they apply to specific patients and retrieves lab data via medical information system. Makes copies of urgent lab data reports phoned in and forwards to the Staff Physician. Attends and participates in training and other meetings to maintain skills and upgrade information provided through collaboration. Performs administrative procedures related to follow-up and tracking. Reference laboratory orders, results and reports on the Government computer systems and records. Communicates with referring laboratories or providers to solve problems. Accessions patients into the laboratory rosters with accession numbers; updates status daily. DCSS Additional COR duties Medical Office Clerk: In addition to the qualifications and requirements in the standard Advanced Office Clerk position description, the following will apply to this task order: The contract staff will operate a call center that manages inbound and outbound calls from beneficiaries, validates beneficiary eligibility, schedules, cancels, and reschedules patient appointments in order to provide timely access to quality healthcare. The contractor shall provide outbound calls in order to schedule specialty appointments for beneficiaries who have received a direct care specialty referral. The contractor staff will record each beneficiary call with the government- supplied computers that interface with the standardized Military Healthcare System GENESIS (MHSG) electronic health record appointing and referral management system. The contractor shall document calls in MHSG using the most current DHA and SDMHS policies. Process appointment requests via Secure Messaging System (SMS), as well as outbound calls for patient care reminders, to include pre-appointment instructions and reminders (lab/radiology/fasting/pre-op surgery, etc.). Generate outbound notification letters to beneficiaries referred to direct care specialty clinics. Verify beneficiary eligibility via the Defense Enrollment Eligibility Reporting System (DEERS) system, updating patient demographic information, and scheduling beneficiary requests for MTF primary or specialty care appointments, as well as completing requests for cancellations and appointment rescheduling. Complete outbound calls to facilitate the timely scheduling of specialty appointments in support of specialty referrals generated by an MTF Health Care Provider (HCP). Conducts outbound calls to facilitate scheduling of preventative health appointments and surgery reminder calls. Schedules and coordinates appointments with other SDMHS MTFs in order to meet beneficiary health care needs within TRICARE access standards. Process Secure Message Service (SMS) transmittal requests for appointments, drive-time mapping capabilities in support of specialty care appointing, as well as outbound letters to beneficiaries referred for MTF specialty care. The contractor shall ensure all staff are familiar with basic medical terminology and Microsoft Office products used with the beneficiary a PAS processes and understand business rules addressing beneficiary category access to the direct care and network systems. The contractor shall ensure that PAS agents possess a functional knowledge of the TRICARE Healthcare Program and are familiar with the terminology and inter-relationships of the ATC categories, appointment types, referral processes, detail codes, provider specialties, and ATC standards. The PAS agents shall receive annual refresher training in these areas, as well as stay abreast with TRICARE Program changes. The contractor shall provide proof of refresher training to the COR annually. The contractor shall ensure PAS agents possess appropriate customer service skills (telephone courtesy). The contractor shall provide trained staff to meet the standardized DHA and Market-specific appointing criteria and business rules IAW DHA IPM 18-001. The contractor shall ensure that phones are continuously staffed with trained personnel, sufficient to handle projected call volumes while achieving all performance standards, during the designated business hours. Appointing agents shall schedule, reschedule, and/or cancel appointments as well as correct appointment- booking errors for all inbound and outbound calls and correspondence IAW DHA business policies and procedures. Appointment Scheduling. After validation of eligibility, the appointing agent shall interpret the beneficiary's request for an appointment and apply the appropriate appointing criteria and directives to the request IAW DHA IPM 18-001. Appointing agents shall match the beneficiary's request for service with the most appropriate ATC category, choosing the appropriate standard appointment types and detail codes that will appoint the beneficiary to an appropriate provider within the applicable DHA ATC standards. Appointment Cancellation Procedures. The contractor shall ensure appointing agents cancel, and if appropriate, reschedule beneficiary appointments at the request of the beneficiary IAW SDM standardized business procedures. If the appointing agent is required to make an outbound call to the beneficiary, the beneficiaries registration information shall be verified and updated, if necessary, and will be compliant with HIPAA, DoD Health Information Privacy Regulation (DoD 6025.18-R), the Privacy Act, and DoD Privacy Program (DoD 5400.11-R). When a cancellation notification is received from the beneficiary, the appointing agent shall cancel the appointment and offer to reschedule the appointment IAW DHA and SDMHS standardized business rules. The Referral agent will cancel the referral in the EHR per DHA IPM 18-001 business rules. If a cancellation request is received from clinic or MTF staff, the appointing agent shall contact the affected beneficiaries and offer to reschedule the appointment IAW DHA and SDMHS standardized business rules. If a cancellation notification is received indirectly from the beneficiary via a recorded message on a contractor provided line or other automated means the appointing agent shall contact the beneficiary in a manner preferred by the beneficiary to determine the need for a new appointment. One recorded attempt shall be made by the appointing agent to contact the beneficiary to determine the need for appointing services. No follow-up is required if the beneficiary left a recorded message indicating a new appointment is not required. Blocked Call Rate. The contractor shall provide sufficient phone lines to ensure there are no blocked calls. 5.1.24 Call Abandonment. The contractor shall provide sufficient personnel to prevent call abandonment. Call Wait Time. The contractor shall ensure a live agent answers all calls within 60 seconds. Defer to Network Patient Option. When MTF specialty access is not available within the TRICARE Access to Care standard, the Contractor will inform patients when a deferral to the network may result in a longer wait time for care than the direct care system using current MCSC data showing network access to care performance by specialty care type. Patients will be given the choice to wait for the next available MTF appointment or to be deferred to network. When patients who choose deferral to network the contractor will modify the referral and route it directly to the MCSC in accordance with DHA and SDMHS business rules. TRICARE for Life (TFL) referrals that cannot be booked within access to care standards will be routed back to MTF Referral Management Offices (RMO) for specialty appointing in the MCSC network in accordance with DHA and SDMHS policy. The COR will provide network "Days to Care" data for each MTF Prime Service Area (PSA) to the contractor monthly as provided by the Managed Care Support Contractor (MCSC). Drive Time Mapping. The contractor shall maximize utilization of direct care capacity and will ensure that beneficiaries are scheduled at a SDM MTF within DHA ATC standards as well as drive time standards from residence to MTF. First Call Resolution. Patients will be scheduled for MTF healthcare appointments in