Clerk, Denials Management

Clerk, Denials Management - 20895

US:

TX:

Edinburg | Health Information Management | Full Time

DHR Health - US:

TX:

Edinburg - Days

Summary:

FLSA STATUS:
Exempt Non-Exempt

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:

POSITION 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.

· Maintains Careport Log

· 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 RESPONSIBILITIES:

(Chain-of-command)

1. Office Supervisor → 2. Sr. Director → 3. CFO → CEO

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
- Standing/Squatting
- Yes

Straight pulling
- Yes
- Sitting
- Yes

Pulling hand over hand
- Yes
- Pushing
- Yes

Repeated bending
- Yes
- Stooping/Bending
- Yes

Reaching above shoulder
- Yes
- Climbing Stairs
- Yes

Simple grasping
- Yes
- Climbing Ladders
- No

Dual simultaneous grasping
- Yes
- Depth Perceptions needed
- Yes

Ability to see
- Yes
- Identify Colors
- Yes

Operating office equipment
- Yes
- Twisting
- Yes

Operating mechanical equipment
- Yes
- Crawling
-…