Clear and Legible Reporting (CLR) Clerk - Healthcare Administration

Federal Staffing Resources•Oklahoma City, OK

17d•Remote

About The Position

The Puget Sound Military Appointing Center (PSMHS) is a centralized services center that serves as the primary point of contact for PSMHS beneficiaries seeking healthcare services. This role is critically important in the healthcare delivery system. The call center manages inbound and outbound calls, validates beneficiary eligibility, and schedules, cancels, and reschedules patient appointments to ensure timely access to quality healthcare. The CLR Clerk will record each beneficiary call according to current DHA and PSMHS policies, process appointment requests via Secure Messaging System, and make outbound calls for patient care reminders, including pre-appointment instructions and reminders (lab/radiology/fasting/pre-op surgery, etc.). This role also involves drive-time mapping for specialty care appointments and sending outbound letters to beneficiaries referred for MTF specialty care. Additionally, the CLR Clerk will monitor care delivered, ensure the retrieval of health care records from civilian providers, and deliver those documents to the beneficiaries' medical records.

Requirements

High school diploma or General Educational Development (GED) equivalency.
Skilled in Word, Excel, Access, and other software programs.
Excellent communication, interpersonal and customer service skills.
Able to define problems and obtain solutions.
Must be able to obtain clearance to access the work site and be granted a Common Access Card (CAC).
Must be able to clearly communicate, verbally and written with coworkers and clinic staff.
Ability to obtain facility security.
Must work remotely within the United States from an approved home address.
Must be available and responsive during scheduled work hours.
Dedicated, private workspace with a door required (no shared/common areas).
Must use company-issued or approved secure equipment only.
Required to have wired (Ethernet) internet connection.
Minimum internet speeds: Download: 50 Mbps.

Nice To Haves

Healthcare administrative experience

Responsibilities

Track and account for all MTF generated specialty care that are deferred to the network until closure.
Process all CLRs into the patient's permanent EHR within three working days of receipt, close the referral, and notify the referring provider and/or Primary Care Manager (PCM) that the CLR is awaiting their review.
Track all STAT, Urgent, and Priority referrals.
Initiate efforts to capture the CLR upon request by the referring provider or no later than 60 calendar days from the date the referral was ordered or as soon as a claim is discovered, whichever occurs first.
Perform periodic monitoring of calls handled by the Appointing, Referral, and CLR agents to identify any customer service or training issues.
Report up to management and stakeholders as required.
Adhere to all rules and regulations including but not limited to HIPAA, TJC.
Foster a positive work environment.
Treat all encounters professionally.
Report details on MTF generated initial specialty care deferred to the network, CLRs uploaded into EHR within 30 and 60 days, total CLR reports not received after 180 days, beneficiary referrals canceled, and CLR error rates.