340B Reviewer Clerk

Community Health Centers of the Central CoastNipomo, CA
Onsite

About The Position

Under the supervision of the Director of 340B Program, the 340B Reviewer Clerk shall perform chart reviews to locate chart notes, consultations, medications and referral orders to support 340B claims. The 340B Reviewer Clerk will work with team members, clinic staff and physicians to ensure all requirements are met. It is the primary purpose of CHCCC to provide the highest quality of total care possible to the patient population it serves. Such a level of quality depends ultimately on the staff's desire and ability to work together, individually, and as a team. The employee is expected to be professional, punctual, maintain regular attendance, cooperative, motivated, and organized at all times.

Requirements

  • Understanding of accounting and finance
  • High school diploma or GED required.
  • Ability to read, analyze, and interpret documents such as safety rules, operating and maintenance instructions, policy and procedure manuals.
  • Ability to respond effectively to the most sensitive inquires or complaints.
  • Ability to write routine reports and correspondence.
  • Ability to speak effectively before groups of patients or employees of organization.
  • Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
  • Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
  • Ability to apply sound judgment in understanding to carry out instructions in written or oral form.
  • Ability to make appropriate job decisions following standard office policies and past precedents.
  • Experience with word processing, spreadsheets, email, and keyboarding required.
  • Microsoft Office and Google Suite skills required.
  • Possession of current, valid, unrestricted California Driver's License (Class C) required.
  • Required to pass a criminal history background check and drug screen upon hire.
  • Annual health examination; annual Tuberculosis skin test clearance or chest x-ray; proof of immunity to MMR, Varicella, and Hepatitis B; proof of Tdap vaccine; during current flu season, must provide proof of influenza vaccine or a signed declination form. If declined, a flu mask is mandatory during flu season.

Nice To Haves

  • Finance background preferred.
  • Excellent command of Excel and working knowledge of EHR preferred.

Responsibilities

  • Uses 340B reports to identify patient charts that require review for chart notes, consultations, medication documentation and referral orders.
  • Performs chart review, identifies presence or absence of required elements.
  • Works with Specialty offices or Referral Department to retrieve the missing consultation documentation.
  • Contacts pharmacies to obtain a copy of the prescription when the consultation documentation does not include medication referenced in 340B claims report.
  • Uses pharmacology references to determine generic from brand name prescription drugs.
  • Works with office staff, medication case managers and physicians to ensure medication reconciliation is completed to reflect medications from 340B claims report.
  • Works with office staff and physicians to ensure referral order is in chart for patients seen by and receiving prescription drugs from consulting specialist.
  • Faxes consultations and prescription slips to Athena for scanning into patient�s EMR.
  • Work with 340B team to verify 340B claims reports.
  • Demonstrates professionalism and provides quality customer service using AIDET Standards.
  • Ability to work with high volume of patients, internal/external customers, and deal with frequent changes, delay or unexpected events.
  • Record 340B receivables.
  • Demonstrates adherence to and observes all safety policies and procedures.
  • Demonstrates knowledge of domestic violence, child and dependent abuse protocols.
  • Demonstrates cultural sensitivity and competence with patients.
  • Maintains and adheres to HIPAA, employee confidentiality, and privileged communications (patient, employee, and corporation).
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