Referrals & Medical Records Clerk

Locations

MD1680
MB1680
1680 Michigan Ave.
Miami Beach, FL 33139, USA

JOB RESPONSIBILITIES

Administrative Duties:

• Route clients/patients to the appropriate areas within the agency.
• Answer phones, check and return voice messages in a timely basis.
• Update patient demographics in agency data system as appropriate.

Referrals/Authorization:

• Verify patient insurance carrier/coverage to ensure proper processing of referrals.
• Respond to all correspondence and task (via letter, email, faxes) in a timely manner.
• Record and maintain patient health records in agency’s database and other data systems.
• Process referrals for patient specialist visits including in house specialist and outside providers (via insurance portals, phone calls, etc.)
• Coordinate appointments for patients with specialists.
• Ensure updates are made in EHR regarding appointments made for specialist, patient attendance and/or comments, etc.
• Process additional information requested by insurance companies for authorizations (medical records, documentation from providers, etc.).
• Assist in authorization denials and appeals on behalf of the patient and document outcomes in record system.
• Identify alternative solutions, as determined necessary by providers, for denied authorizations.
• Ensure external 3rd party documentation (i.e. labs, consultation reports, etc.) is collected and entered in the patient’s electronic health records (EHR).
• Ensure proper and timely closing of tasks as it relates to referrals and open orders via EHR.

Medical Records:

• Receive and document medical records requests from outside agencies (Social Security Administration, legal offices, outside providers or patient request)
• Prepare invoices for payments of medical records request.
• Prepare medical records as requested by printing from EHR and prepping for faxing or mailing.
• Ensure documentation for new patients is collected and recorded in patient’s electronic health records (EHR).
• Ensure patient documentation is fully completed and recorded in agency’s database.
• Ensure appropriate assignment to the provider upon receiving records and closure of task by the provider, once the records are obtained.

Quality Assurance/Compliance:

• Assist in ensuring that the medical office (front desk and waiting area) is kept clean and tidy at all times.
• Ensure online training is current as required (My LearningPointe and other trainings).
• Ensure that medical operations fully comply with agency and HIPAA requirements.

Safety:

• Ensure proper hand washing according to the Centers for Disease Control and Prevention guidelines.
• Understands and appropriately acts upon assigned role in Emergency Code System.
• Understands and performs assigned role in agency’s Continuity of Operations Plan (COOP).

Culture of Service: 3 C’s

• Compassion – Greet internal or external customers (i.e. patient, client, staff, vendor) with courtesy, making eye contact, responding with a proper tone, and nonverbal language.
• Listen and reassure – Listen to the internal or external customer attentively, reassuring, and understanding of the request and providing appropriate options or resolutions.
• Competency – Provide services required by following established protocols and when needed, procure additional help to answer questions to ensure appropriate services are delivered.
• Commitment – Take initiative and anticipate internal or external customer needs by engaging them in the process and following up as needed; prioritize requests to ensure prompt and effective response.

Contact Responsibility

The responsibility for external contacts is constant and critical.

Physical Requirements

This work requires the following physical and sensory activities: constant sitting, hearing/visual acuity, talking in person, and on the phone. Frequent walking, standing, sitting, and bending. Work is performed in-office setting.

Other

Participates in health center developmental activities as requested.

Other duties as assigned.

Job Knowledge and

Skills:

Bilingual (English Spanish) is preferred. Computer knowledge should include Microsoft Outlook, Word, and Excel. Excellent problem solving, communication, organizational and teamwork skills are required. The ability to work with a…