Overview
FirstHealth of the Carolinas is a nationally recognized health care system located in central North Carolina. Comprised of four hospitals with more than 600 beds, the system also offers leading-edge heart care in the Reid Heart Center, the area’s only dedicated heart and vascular center. Our growing health system has more than 6,200 employees serving in more than 75 locations throughout a 15-county service area. In addition, FirstHealth has received numerous accolades for its patient care and outcomes, including recognitions from Healthgrades, U.S. News & World Report, and Becker's Healthcare.
Responsibilities
Position Specific Competencies: Medical Office Assistant
In addition to the following essential position competencies, other competencies may be required to meet changing organization needs.
1. Uses an appropriate problem-solving approach to plan services.
- Answers phones, routes calls and takes accurate messages. Demonstrates a sense of urgency relating to patient’s level of distress. Triages basic patient care needs generating a telephone encounter depending upon the situation.
- Registers new patients and maintains current accurate up-to-date demographic and insurance information for all patients. Performs according to policy regulations associated with Privacy Notification, Medicare secondary, signed demographic registrations, consent to treat minor, etc. (MSPQ).
- Identifies barriers to care.
- Verifies insurance eligibility, scans insurance card, and photo ID.
- Checks patients in and out for visits accurately. Uses ICD-10 and CPT codes appropriately.
- Accurately posts payments according to policy.
- Reconciles all financial data correctly and in compliance with clinic policy, both end of day and end of month.
- Forwards requests for Medical Records to Health Information Management Systems.
- Works with patient and clinic manager to effectively manage patient accounts and performs certain financial assistance tasks as delegated and monitored by the clinic.
- Recognizes how fraud and abuse interplay into daily operations.
- Performs any other duty as assigned within the scope of practice for a MOA by the clinic manager.
- Contacts facilities as necessary to ensure the appropriate paperwork is indexed in the patient’s EMR medical record prior to being seen by the provider in preparation for patient appointments – Examples: surgical reports, pathology reports, home health summary of care, etc.
- Responds to the follow-up action plans sent by providers aimed at achieving maximum level of care continuity in preparation for designated patient appointments.
- Monitors the Quality Panel Metrics Health Maintenance Tab to facilitate proactive management of patient care and close care gaps.
2. Provides services with consideration of the recipient’s needs.
- Maintains work area in a neat and organized manner.
- Secures patient information in desk drawers or locked filing cabinets.
- Secures all receipts and cash drawer under lock and key overnight and when away from work area. Locks computer system as needed when away from work desk to protect PHI for patients.
- Greets and directs patients and visitors in a courteous manner, informing them of delays or changes in patient flow.
- Manages appointment schedule to ensure provider efficiency and patient satisfaction.
- Monitors the reception area to ensure patient comfort and prompt response to patient distress or concerns.
- Wears FH name badge and introduces self to patients as needed.
- Works on behalf of patients and occupational health clients to ensure timely appointments by asking patients to arrive early, effectively working through paperwork, history forms, etc. while ensuring patients have the opportunity to reschedule if the provider is running late.
- Monitors and manages patient and client requests for appointments.
- Manages occupational health no-shows; monitors upcoming occupational health schedules.
3. Uses equipment/supplies correctly.
- Maintains equipment in proper working condition. Follows manufacturers’ manuals for care of office equipment. Notifies manager of equipment failure.
- Maintains adequate supply of materials and uses supplies conservatively.
- Keeps a neat, orderly, and safe work environment.
4. Uses appropriate safety and infection control measures.
- Adheres to established infection control protocols.
- Assures patient safety by following applicable patient safety guidelines.
5. Teaches/directs/advises/informs others in an appropriate manner.
- Communicates clearly with providers, manager, co-workers, and patients.
- Educates and informs patients about clinic policies, procedures, and processes using basic, simple language and principles of adult learning.
- Involves clinic manager in all patient concerns/complaints in a timely fashion after first trying to diffuse the situation.
- Accurately collects co-pays and deductibles; provides patients with necessary information about their insurance policy (when information is available) as needed.
- Advises patients in need of insurance pre-certifications or authorization for clinic visits (i.e., managed care and VA).
- Knowledge of managed care plans is essential.
- Adheres to FirstHealth’s Customer Service Standards.
6. Reports/records information appropriately.
- Uses approved format for recording and reporting i.e., telephone encounter, etc.
- Maintains written reports of all situations requiring manager’s attention.
- Reconciles cash receipts and reports as instructed by policy when MOA must leave money drawer for an extended period.
- Utilizes the EHR/EMR system if in place to facilitate role as it relates to referrals, follow-up patient instructions, or other activities required in a clinic setting to augment quality for patient care and coordination.
Compliance to competencies is evaluated by Outstanding, Successfully, and Needs Improvement. It is the judgment of the clinic manager and supported by objective documentation under comments when either Outstanding or Needs Improvement are given to any of these competencies.
Qualifications
Qualifications:
The following, or equivalents, are the minimum requirements necessary to perform the essential functions of the position.
Education/formal training/licensure/certifications/experience:
High school graduate. One-year Technical College or certification preferred.
Three years' experience in a physician office with medical billing experience may be accepted in lieu of formal training.
Additional Skills:
Experience with practice management systems; office automation skills; extensive knowledge of CPT and ICD-10 coding and insurance reimbursement; strong interpersonal and verbal communication skills; good organizational skills. Is committed to and demonstrates excellent customer service when dealing with all types of customers.