Off-panel Coordinator/Clinical Records Specialist

Davis Behavioral Health•Layton, UT

7d•$20 - $22•Onsite

About The Position

Davis Behavioral Health (DBH) is actively recruiting for a part-time Off-panel Coordinator/Clinical Records Specialist to join its compliance team. The Off-panel Coordinator manages relationships and clinical details with our contracted private providers and agencies, ensuring quality care is being provided. Essential Job Functions Off-Panel Coordinator The Off-panel Coordinator/Clinical Records Specialist is responsible for performing the following essential job functions at the expected level and within the expected timeframes: Responsible for all Off-panel Provider activities, including but not limited to: Complete the full contract process for all off-panel contract providers, including application, document collection, and all other required steps in the process. Complete all functions related to developing and maintaining off-panel contract relationships through active collaboration to answer questions, schedule required meetings, coordinate client referrals, and all other related tasks. In coordination with the Corporate Compliance Office, initiate and complete the authorization process for clients requesting services with off-panel contract providers. Ensure that clients receiving services are following the authorized frequency and duration. Process all required forms and documentation to ensure timely and accurate payment for services rendered. As outlined in the off-panel contract, approved billing will be paid within 45 business days following approval. Complete annual contract renewals using the approved off-panel contract protocols and within established timeframes. Notify all internal parties when contracts are not renewed to terminate all related processes (i.e., DACS background screening, disable EHR access, etc.). Initiate pre-audit tasks for the annual clinical audit for all off-panel providers, including correspondence, document collection, and other related tasks. Audit is completed by the DBH Corporate Compliance Officer. Address all denials and appeals within established timeframes to ensure contractual compliance and timely payment. Coordinate with the DBH Provider Network Specialist on all other activities related to the off-panel contract providers. Complete ECT authorizations and billing within established timeframes. Residential Placements Work as liaison between DBH and potential residential placement agencies, coordinating with DBH Program Directors and staff at the placement agency to facilitate placement, as needed. Complete authorization letter. Complete follow-up on placement at defined date (30/60 days) for clinical review. Maintain the spreadsheet to track all services, expiration dates, payment dates, appeals, and other information related to off-panel providers. Clinical Records Specialist Under the direction and guidance of the Corporate Compliance Officer, and in accordance with federal and state privacy laws/rules and internal policies and procedures, oversee the release of information (ROI) processes at DBH. Provide training to DBH staff about the client records release process, as requested and supervised by the DBH Corporate Compliance Officer. Authorization to Use and Disclose Health Information (TPO – Treatment, Payment, and Operations & Non-TPO) Follow the established protocol to accurately process all Authorization to Use and Disclose Health Information forms within the established timeframes. Complete all preparations for copy services of client records. Coordinate with Datavant to ensure that DBH follows their established processes for client records release. Provide excellent customer service to DBH staff, clients, and community partners to address status updates and all other questions about the client record release process. Client Requests for Own Records Follow the established protocol to accurately process all Client Request for Own Records forms within the established timeframes. Calculate fee Coordinate with client and treatment provider(s) Complete redaction process, as requested by treatment provider(s). All other tasks related to the established protocol. Coordinate the subpoenas for client records with the treatment provider(s), Corporate Compliance Officer, and DBH Legal Counsel. Other duties and responsibilities and needed and assigned. Additional Job Functions In addition to the essential job functions outlined above, the following responsibilities are assigned to this position: Complete all steps to process secondary capitated Medicaid payments for providers in the community, including denials. Serve as back up for the Hospital Liaison, as needed. Schedule and ensure that quarterly fire drills are completed for all required programs as outlined by the State of Utah Department of Health and Human Services Office of Licensing rules.

Requirements

Bachelor's degree in health administration, health information management, health information technology, or related field. A combination of education and direct professional experience working in a similar role may be substituted for education.
Complete all required training that is assigned to the Off Panel Coordinator, HIPAA Specialist position by defined deadlines. Additional training specifically related to HIPAA, and related privacy and security may be required.
Be fully trained in the Hospital Liaison essential job functions to complete them within established timeframes to ensure continuity of services when backing up this role.
Previous experience working in a medical or healthcare office or clinic.
Must be at least 18 years old.
All employees at DBH must successfully pass a pre-employment criminal background check as well as a pre-employment drug screening.
Since Davis Behavioral Health works with Federal grants the company and its employees must comply with the Federal drug laws, including no use of medical marijuana.
The Off-panel Coordinator/HIPAA Specialist must possess strong verbal communication skills and have demonstrated professional customer service experience.
The successful candidate must also demonstrate compassion, courtesy and respect to all clients and their families.
Exceptional interpersonal skills with the ability to establish immediate rapport with clients.
Successful applicant must be flexible and willing to perform some intake work, records, and other office duties.

Nice To Haves

Previous experience with HIPAA and privacy regulations is preferred but not required.
Spanish speaking is a bonus.

Responsibilities

Complete the full contract process for all off-panel contract providers, including application, document collection, and all other required steps in the process.
Complete all functions related to developing and maintaining off-panel contract relationships through active collaboration to answer questions, schedule required meetings, coordinate client referrals, and all other related tasks.
In coordination with the Corporate Compliance Office, initiate and complete the authorization process for clients requesting services with off-panel contract providers.
Ensure that clients receiving services are following the authorized frequency and duration.
Process all required forms and documentation to ensure timely and accurate payment for services rendered.
Complete annual contract renewals using the approved off-panel contract protocols and within established timeframes.
Notify all internal parties when contracts are not renewed to terminate all related processes (i.e., DACS background screening, disable EHR access, etc.).
Initiate pre-audit tasks for the annual clinical audit for all off-panel providers, including correspondence, document collection, and other related tasks.
Address all denials and appeals within established timeframes to ensure contractual compliance and timely payment.
Coordinate with the DBH Provider Network Specialist on all other activities related to the off-panel contract providers.
Complete ECT authorizations and billing within established timeframes.
Work as liaison between DBH and potential residential placement agencies, coordinating with DBH Program Directors and staff at the placement agency to facilitate placement, as needed.
Complete authorization letter.
Complete follow-up on placement at defined date (30/60 days) for clinical review.
Maintain the spreadsheet to track all services, expiration dates, payment dates, appeals, and other information related to off-panel providers.
Under the direction and guidance of the Corporate Compliance Officer, and in accordance with federal and state privacy laws/rules and internal policies and procedures, oversee the release of information (ROI) processes at DBH.
Provide training to DBH staff about the client records release process, as requested and supervised by the DBH Corporate Compliance Officer.
Follow the established protocol to accurately process all Authorization to Use and Disclose Health Information forms within the established timeframes.
Complete all preparations for copy services of client records.
Coordinate with Datavant to ensure that DBH follows their established processes for client records release.
Provide excellent customer service to DBH staff, clients, and community partners to address status updates and all other questions about the client record release process.
Follow the established protocol to accurately process all Client Request for Own Records forms within the established timeframes.
Calculate fee
Coordinate with client and treatment provider(s)
Complete redaction process, as requested by treatment provider(s).
All other tasks related to the established protocol.
Coordinate the subpoenas for client records with the treatment provider(s), Corporate Compliance Officer, and DBH Legal Counsel.
Complete all steps to process secondary capitated Medicaid payments for providers in the community, including denials.
Serve as back up for the Hospital Liaison, as needed.
Schedule and ensure that quarterly fire drills are completed for all required programs as outlined by the State of Utah Department of Health and Human Services Office of Licensing rules.
Answer telephones and route calls based on requests or subject matter
Schedule, reschedule, and cancel appointments
Provide information to the public
Greet walk-in and potential clients
Refer clients to appropriate staff
Accept payments
Data entry
Process and maintain variety of records, file, type, distribute mail, complete end-of-day receipts
Complete other tasks as assigned
Perform some intake work, records, and other office duties