Clerk, Denials Management - 20895

DHR Health; Edinburg, Northern (TX, KY); Hybrid; USD 32,000 - 45,000; Full time

Job summary

DHR Health is seeking an administrative professional to support the Denials Team in Edinburg, Texas. You will provide secretarial and clerical assistance, manage records, and ensure accurate, confidential handling of information within the Health Information Management area.

The role requires strong communication skills, organizational abilities, and proficiency with office software. Hospital experience is preferred and English fluency is essential.

Qualifications

• High School Diploma/GED preferred.
• Prefer hospital experience.
• Office experience is preferred.
• Organizational skills is necessary.
• Good written and verbal communication skills required.
• Ability to read, write and speak English.
• Ability to communicate clearly with nursing, administration, and physicians.
• Secretarial experience is preferred.

Responsibilities

• Promotes the facility mission, vision and values in daily work.
• Perform necessary functions on the facility computer system.
• Collaborate with Denials on report discrepancies.
• Establishes and maintains confidential record-keeping and filing.
• Maintain attention to detail and paperwork required to the role.
• Prints and faxes correspondence reports promptly.
• Screen telephone calls and route them appropriately.
• Inform management of urgent situations and status of appeals in Careport.
• Monitor and correct duplicate records in Careport.
• Notify supervisor of delays in tasks in Careport.
• Other duties as assigned.

Skills

Written and verbal communication

Organizational skills

English reading/writing/speaking

Office software proficiency

Secretarial experience

Education

High School Diploma/GED

Job description

US:TX:Edinburg | HEALTH INFORMATION MANAGEMENT | Full Time

Summary:

MISSION STATEMENT:

Our Mission is to improve the well-being of those we serve with a commitment to excellence: every patient, every encounter, every time.

VISION:

Our Vision is to create a world-class health system to advance medicine and increase access for the communities we serve by empowering caregivers to heal through compassion, knowledge, innovation, integrated care and excellence.

POSITION SUMMARY:

Provides secretarial and administrative support services to Denials Team.

POSITION EDUCATION/ QUALIFICATIONS

• High School Diploma/GED preferred
• Prefer hospital experience
• Office experience is preferred
• Organizational skills is necessary
• Good written and verbal communication skills required.
• Ability to read, write and speak English
• Ability to communicate clearly and concisely with all levels of nursing, administration, and physicians
• Prefer hospital experience
• Secretarial experience is preferred

JOB KNOWLEDGE/EXPERIENCE

• High degree of competency/experience in general.
• Requires good communication and organizational skills.
• Requires reasoning ability and good independent judgment.
• Requires working with frequent interruptions.
• Must project a professional image.
• Must possess working knowledge of personal computers and software applications used in job.

RESPONSIBILITIES

• Promotes the facility mission, vision and values by effectively communicating them to others. Considers mission, vision and values in developing services, standards and practices
• Able to perform the necessary functions on the facility computer system.
• Works collaboratively with Denials on report discrepancy.
• Establishes, maintains and revises record keeping and filing systems, ensuring confidentiality of information.
• Consistently is attentive to detail, record keeping and required paperwork inherent to the position.
• Prints/faxes correspondence reports in a timely manner.
• Accepts and screens telephone calls and routes calls appropriately.
• Informs management when the situation warrants immediate attention.
• Informs Management on status of appeals from Careport
• Monitors & corrects any duplicate records in Careport
• Informs immediate supervisor of any delays in assigned tasks in Careport
• Other duties as assigned

OTHER INFORMATION

LINES OF REPSONSIBILITIES

(Chain-of-command)

CUSTOMER SERVICE

Provide excellent customer service to all DHR customers. All employees are required to attend the DHR C.A.R.E.S program which outlines the Customer Service Principals including: Commitment, Accountability, Respect, Excellence and Service.

AGE SPECIFIC

Employees must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served in his/her assigned unit. The individual must demonstrate knowledge of principles of growth and development over the life span and possess the ability to assess data reflective of the patient’s status and interpret the appropriate information needed to identify each patient’s requirement relative to his or her age.

AMERICANS WITH DISABILITIES ACT: (ADA)

A. Essential Duties: Indicated by bold print within performance standards, preceding individual numbered criteria.

The following table provides physical requirements that will be associated with, but not limited to, this position:

Light/moderate lifting up to 20 lbs, from the floor to shoulder height.

Yes

Kneeling

Yes

Must be able to assist other employees with lifting more than 20 lbs.

Yes

Walking

Yes

Light/moderate carrying up to 20 lbs.

Yes

Yes

Straight pulling

Yes

Yes

Pulling hand over hand

Yes

Pushing

Yes

Repeated bending

Yes

Yes

Reaching above shoulder

Yes

Yes

Yes

Climbing Ladders

No

Dual simultaneous grasping

Yes

Depth Perceptions needed

Yes

Ability to see

Yes

Yes

Operating office equipment

Yes

Twisting

Yes

Operating mechanical equipment

Yes

No

Ability to read and write

Yes

Ability to Count

Yes

Ability to hear verbal communication without aid

Yes

Operating Personal Vehicle

Yes

Ability to comprehend written/verbal communication

Yes

Other: Ability to deal with stress

Yes

OSHA Category

III

B. Working Conditions: The individual spends over 95% of his/her time in an air-conditioned environment with varying exposures to noise. There is protection from weather conditions but not necessarily from temperature changes. The position does have low exposure to malodorous, infectious body fluids from patients and some minimal exposure to noxious smells from cleansing agents.

C. Occupational Exposure: This position has minimal to no exposure to blood, body fluids, or tissues and is an OSHA Category III (although situations can be imagined or hypothesized under which anyone, anywhere, might encounter potential exposure to body fluids). Person who performs these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid or to be potentially exposed in some other way.

Intelligence: General learning ability: The ability to “catch on” or understand instructions and underlying principles. Ability to reason and make judgments. 3

Verbal: Ability to understand meanings of words and ideas associated with them, and to use them effectively. To comprehend language, to understand relationships between words, and to understand meanings of whole sentences and paragraphs. To present information or ideas clearly. 3

Numerical: Ability to perform arithmetic operations quickly and accurately. 2

Spatial: Ability to comprehend forms in space and understands relationships of plane and solid objects. Frequently described as the ability to “visualize” objects or two or three dimensions, or to think visually of geometric forms. 2

Form Perception: Ability to perceive pertinent details and objects or in pictorial or graphic material to make visual comparisons and discriminations and see slight differences in shapes and shadings of figures and widths and lengths of lines. 3

Clerical Perception: Ability to receive pertinent details and verbal or tabular material. To observe differences in copy, to proofread words and numbers, and to avoid perceptual errors in arithmetic computation. 2

Motor Coordination: Ability to coordinate eyes and hands to fingers rapidly and accurately in making precise movements with speed. Ability to make a movement response accurately and quickly. 3

Finger Dexterity: Ability to move hands easily and skillfully. To work with fingers in placing and turning motions. 3

Manual Dexterity: Ability to move hands easily and skillfully. To work with hands in placing and turning motions. 3

Eye-Hand-Foot Coordination: Ability to move the hand and foot coordinately with each other in accordance with visual stimuli. 3

Color Discrimination: Ability to perceive and respond to similarities or differences in colors, shapes, or other values of the same or different color. To identify a particular color, or to recognize harmonious or contrasting color combinations, or to match color adequately. 3

I have read and reviewed my job description with my supervisor or designee and I understand the job I am expected to perform.

If applicable ____________ certification will be completed within _________ time frame of hire/transfer date.

Employee Signature: ________________________________ Date: ____________________