Clerk, Denials Management

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.

• 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

• 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.

• 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

(Chain-of-command)

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.

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.

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…