Medical Office Specialist-McAllen Medical Plaza

DRISCOLL HEALTH PLAN•McAllen, TX

39d

About The Position

Where compassion meets innovation and technology and our employees are family. Thank you for your interest in joining our team! Please review the job information below. Where compassion meets innovation and technology and our employees are family. General Purpose of Job Reporting to the department clinical coordinator, this position is responsible for the support functions necessary to accomplishing the objective of the department. These include, but are not limited to functions under the categories of telephone support, patient accounting, clinical support, patient scheduling, registration and patient discharge. Essential Duties and Responsibilities : To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and / or hospital administration as required.

Requirements

High school diploma or general education degree (GED); or one to three months related experience and / or training; or equivalent combination of education and experience.

Responsibilities

Maintains utmost level of confidentiality at all times.
Adheres to hospital policies and procedures.
Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines.
Provides professional and courteous telephone support for all incoming telephone calls.
Designs, types and reproduces patient education forms and clinical handouts.
Designs, types and produces all correspondence as requested by CARE Team members including typing agendas, preparing for lectures.
Keeps track of needed supplies
Personally contacts the PPO’s, PCP’s, Medicaid or other special funding sources, daily to secure the appropriate authorization for ancillary services ordered.
Interfaces with clinical staff and performs a medical record review to obtain the patient’s clinical history needed prior to performing the authorization process.
Interfaces with insurance companies to provide patient clinical information, and ICD9 and CPT codes for ordered services.
Composes, types and faxes communications to PCP office regarding any special test request needed by specialist as per HMO guidelines.
Coordinates referral arrangements for ordered ancillary services with patient families.
Documents requests for letters of medical necessity correspondence and certificates of medical necessity requested by insurance carriers.