FT•Days•Eye Institute Dr.

Gelman DHR Health

3.3 Edinburg, TX Job Details Full-time 1 hour ago Qualifications Appeals Customer communication Insurance claim appeals processing English High school diploma or GED Medical insurance appeals management Hospital regulatory compliance Full Job Description 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

This position ensures quality services by acting as a liaison between all potential clients including general public, physicians, physician office staff, management and hospital staff. The Office Manager will coordinate the staffing of front desk, medical assistants, ancillary providers and take care of the needs of physicians and providers in each location. Participates in volunteer programs and special assignments, and performs other duties as assigned within scope of practice.

POSITION EDUCATION/ QUALIFICATIONS

High school diploma or equivalent is required; Associate or Bachelor Degree preferred Minimum five (5) years demonstrated leadership in a health care organization preferred Knowledge of regulatory requirements (state, federal and The Joint Commission, or other relevant area) Must be able to be sensitive to cultural and bilingual issues Organizational skills are required along with good written and verbal communication skills Ability to read, write and speak English Ability to communicate clearly and concisely with all levels of management including: nursing, administration, and physicians Medical office experience and supervisory experience is required Some evening or weekend work will be required

JOB KNOWLEDGE/EXPERIENCE

Five (5) years of experience in a healthcare with setting proven results in: clinical operations oversight, billing, and collections, to include denial and appeals operations. Five (5) years of experience in a supervisory position is required Ability to interact with providers on a personal and professional level Exercises a high degree of initiative, reasoning, good judgment, discretion, and decision

making to achieve organizational objectives Ability to conduct medical practice assessments, evaluate data and recommend action plans Capable of understanding the goals of the health system and works to attain these goals

Responsibilities:

POSITION RESPONSIBILITIES

Supervises the activities performed in all work units within the each practice including practice management, implementation of procedures, case management and processing, records management, billing and collections and reporting of statistics, and accounting functions Personnel Performs personnel administrative tasks, including coordinating and participating in the hiring and promotion process, supervising the training of new employees and the ongoing training of other employees, resolving unusual employee problems, and supervising employee time and attendance records.

Maintains personnel files for each employee to include training acknowledgements: o Application o Terms of employment o HR Policy Absenteeism/tardiness HR-1003 o HR Policy Cellular Camera/Phone/Hand Held Device Use HR-1007 o HR Policy Discipline HR-1012 o HR Policy Paid Time Off ( PTO) HR-1037 o HR Policy Dress Code HR-1013 o HR Policy Work Rules and Regulations HR-1054 o Reporting Incident report training o Probationary & Annual performance evaluations with physician input as needed o OSHA training/exposure control o HIPAA Training o Hazard Communication Training o Fraud & Abuse Prevention Training o Kronos•Time Keeper Training o Uniform order form copy o Application For Computer Privileges o Computer User and Protected Information Access Confidentiality and Non-Disclosure Agreement o Authorizes overtime with justification o Responsible for pre-approving vacation request for all team members.

Responsible for blocking clinic schedules according to physician vacation, PTO, administrative holidays and CME dates
Responsible for scheduling to cover temporary and/or open positions
Responsible for rectifying all personnel problems as they relate to office efficiency and effectiveness
Responsible for keeping current on work and/or overtime policies
Responsible for keeping current on legal issues as pertaining to Confidentiality, Documentation, Consent forms, Accountability for controlled substances
Actively seeks ways to improve level of clinic performance
Payroll editing, review and approval Team Meetings Responsible for holding the following: daily huddles, monthly meeting with all team members, and monthly meeting with physicians. Responsible for providing weekly follow up and feedback on required actions based on meeting discoveries through Agenda and sign-in sheets. Supervision
Maintains clinic schedule to assure coverage for all physician(s)/shifts(s), optimizing team members resources
Hires team members and facilitates training as needed
Supervises and coordinates the work of team members , through assigned team leads including reviewing work performance, motivating subordinates to work more effectively, identifying problems with performance and developing solutions to those problems, determining training needs to improve performance, initiating informal measures to correct misconduct or making recommendations for formal discipline • Schedules regular in-service programs to keep team members current • Responsible for staying current with state and federal regulations which govern the clinical environment Financial Management • Operates within the context of an established budget • Assures that accounts payable are properly managed by submitting invoices within 72 hours of receipt for processing • Keeps physician(s) aware of office activity on a weekly basis in regard to: o Number of patients seen or not seen o Any growth or declined patterns noted o Any other statistics as may be required • Responsible for overseeing the balancing of the petty cash account weekly • Reviews on a daily basis payment logs for inaccuracies/completeness • Establishes and implements financial controls • Submits completed information for physician reimbursement and keep track of check processing until physician reimbursement is received • Responsible for completing physician metric information by the 4th of each month as outlined by physician employment agreement • Responsible for review of daily billing for inaccuracies/completeness • Responsible for clinic monies to be deposited daily and reviews for inaccuracies/completeness • Responsible for reviewing monthly clinic financials and identifying areas of improvement • Responsible for delivering physician Work RVU monthly production report as assigned • Responsible for daily, weekly and monthly internal audits of physician billing submitted to validate accuracy • Works closely with team member, billing company, and revenue cycle for billing compliance, timely closing/submission of daily office, and hospital charges • Ensures billing batches are submitted timely and Batch Calendars are updated appropriately Clinic Operations Oversees daily office operations and delegates authority to assigned team members Assists team members in developing and implementing short•and long-term objectives for front desk functions Assists team members in understanding/implementing clinic procedures Ensures appropriate team staffing levels to maintain efficient work flow in the clinic • Supports and upholds established policies, procedures, quality improvement, safety, environmental and infection control • Maintains requirements of accreditation and regulatory agencies, ie Joint Commission • Assures proper maintenance of all office equipment, schedules maintenance and upgrades of equipment an recommends purchase of new equipment Ensures Radiation equipment maintains TDH licensure and QC program is properly implemented Ensures that physician DEA, DPS, Malpractice, Texas Medical licensure and other required documents are kept current Ensures that updated physician calendars are submitted prior to payroll close for accounting comparisons to contracts Handles complaints from patients or referring physicians with excellent customer service skills and monitors patient service feedback and helps resolves complaints and service issues Is required to contact patient directly and start the first step to service recovery with emphasis on the importance of improving the \"patient experience\" Manages daily operations at satellite offices, coordinates the work activities and schedules ,develops goals to ensures they align with organization goals Oversees and ensures that mail is opened and processed daily Monitors that the offices are opened and closed according to posted operating hours OSHA • Responsible for assuring that there is an OSHA plan in regard to: blood-borne pathogen program, hazardous chemical communication, bio-hazardous waste tracking and exposure control plan • Assures that all team members understand how to dispose bio-hazardous waste: sharps, contaminated supplies, and chemicals • Responsible for scheduling employee in-service meetings to familiarize team members of mandated information • Responsible for assuring clinic compliance signage, lab, eyewash station as needed Insurance Contracts • Responsible for understanding insurance payer contract requirements • Responsible for understanding and implementing all contract components • Responsible for communicating any changes or requirements for authorizations to team members involved Medical Record Activity Responsible for clinics maintaining a current, accurate medical record Responsible for assuring accurate and timely entries of pertinent medical information on all patients: o Phone messages by patients o Reports from outside facilities o Progress notes o Refills/prescriptions o No Shows/cancellations Responsible for assuring quality, confidentiality and timeliness of all transcription activities, whether, preformed in-house or by an outside vendor Responsible for maintaining a policy to assure confidentiality of Medical Records Office Maintenance • Ensures that physical office is properly maintained and functional by communicating with o EVS services o Landscaping services o Pest Control services o Engineering for repairs/other regular maintenance o Utilities Time Management • Assists the physician(s) with time and calendar management • When necessary acts as a liaison between the physician(s) and organizational departments and vendors • Practice Enhancement Marketing • Responsible for the submitting requested information to marketing department • Performs physician and patient correspondence as necessary to promote positive relationships • Responsible for representing practice as deemed necessary by the foundation o Updating physician directory o Health screening w/MDs o Special events o Other • Represents the practice through participation in local professional associations and community activities, etc.

Performs any and all other duties which may be required to assure proper administration and management of the practice Other duties as assigned Other information:

LINES OF REPSONSIBILITY

(Chain-of-command) 1. Director DHR Health Clinics 2. Chief Ambulatory Officer 3. Assistant VP Ambulatory Clinical Operations

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 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. D.

Aptitudes:

HIGH 1 2 3 4 5 6 LOW

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:

____________________

Transfer/Hire Date Effective:

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Office Manager - FT - Days - Eye Institute Dr. Gelman