Technical Records Specialist 2, University Health Center (8131)

Idaho State University

1d•Onsite

About The Position

This position provides technical support for programs and organizational activities, focusing on conveying information, ensuring compliance, and resolving difficult situations. The role requires expertise in implementing and maintaining technical program guidelines. The successful candidate will manage all front office clinic services, including patient scheduling, handling telephone inquiries, collecting patient fees, coordinating referrals, managing insurance billing, posting payments, ensuring compliance, and resolving complex situations with various constituents. Responsibilities also include document management within Electronic Medical Record and Financial systems, and overseeing daily clinic operations as directed by the University Health Business Operations Manager. The specialist will perform detail-oriented tasks with complete accuracy to optimize clinic revenue cycle management and will operate with considerable independence and discretion in applying policies and procedures when interacting with patients, vendors, and insurance companies. This is a full-time position with a regular work schedule of 32 hours per week.

Requirements

Experience monitoring record systems to identify and correct errors.
Experience interpreting, explaining, and applying laws, regulations, and complex policies for multiple or highly specialized programs.
Experience analyzing information and researching a variety of sources to identify and resolve problems or issues.
Experience dealing with individuals from varying cultural and socio-economic backgrounds in stressful situations.
Experience entering and retrieving data using a computerized record system.
Experience composing and proofreading business correspondence.
Experience storing, retrieving and compiling information in a report format using database software.
Experience reviewing/assessing health care claims.
Experience reviewing/assessing dental claims.
Experience working with sensitive or restricted data.

Nice To Haves

Some knowledge of data management.
Some knowledge of financial record keeping.
Some knowledge of mental health and substance use disorders programs and terminology.
Good knowledge of University academic and/or vocational program requirements and experience applying university policies and procedures to determine graduation requirements.

Responsibilities

Maintain patient electronic medical records and ensure information is complete and accurate (Electronic Medical Record System Management).
Create new patient accounts including patient demographics and insurance and/or payor information (Patient Management).
Process and monitor insurance authorizations and coordinate with outside Physicians to obtain medical documentation and prescriptions for care (Patient Management).
Contact insurance to verify benefits and eligibility and discuss payment and billing options with patients (Patient Management).
Maintain clinic schedule for all patients and clinical providers (i.e. PA, MD, DO, Nutritionist) (Scheduling).
Review charges and research denied claims (Billing).
Print and post patient payments (Billing).
Create monthly billing statements and resolve billing issues as necessary with patients (Billing).
Collect and deposit patient and insurance payments with complete accuracy (Revenue Cycle Management).
Balance daily gross and net collections (Revenue Cycle Management).
Compare checks/cash collected daily (Revenue Cycle Management).
Prepare and validate deposit (Revenue Cycle Management).
Manage patient accounts to ensure that revenue is collected in a timely manner (Revenue Cycle Management).
Negotiate payment plans as necessary (Revenue Cycle Management).
Perform patient check-in (Clinic Operations).
Answer phone calls and address routine questions regarding appointments, insurance billing, payments and collections (Clinic Operations).
Receive faxes and route as necessary (Clinic Operations).
Fax medical documentation as necessary to local physicians and insurance companies upon request (Clinic Operations).
Maintain old patient files and process requests for patient information (Clinic Operations).
Comply with HIPAA regulations including interpreting, explaining, and applying laws, regulations, and complex policies (Clinic Operations).
Manage clinic mail (Clinic Operations).
Ensure that clinic licenses are up to date and submit to Clinic Operations Director for credentialing (Clinic Operations).
Manage relationships with patients, outside health care providers, insurance companies, vendors and purchasing processes (Clinic Operations).
Coordinate with clinicians to ensure documentation is returned within insurance and Medicaid guidelines (Insurance/ Medicaid Compliance).
Work with clinicians to make sure documentation is complete in a timely manner (Insurance/ Medicaid Compliance).
Assist the University Health Center Business Operations Manager in special projects as needed to support clinic operations (Clinics Director of Operations Support).
Create Purchase Orders and requisitions, ensure funding is assigned (Clinics Director of Operations Support).
Submit and track invoices (Clinics Director of Operations Support).