Job Description
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 to the internal or external customer (i.e. patient, client, staff, vendor) 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 internal or external customer (i.e. patient, client, staff, vendor) requests to ensure the prompt and effective response is provided Safety Ensure proper handwashing according to the Centers for Disease Control and Prevention guidelines. Understands and appropriately acts upon the assigned role in Emergency Code System. Understands and performs assigned roles in the organization's Continuity of Operations Plan (COOP). 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 and laboratory settings. 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 multicultural and diverse population is required. Legal Compliance Notice:
This careers website is maintained by Care Resource Community Health Centers, Inc., a qualified entity, in support of compliance with House Bill 531 (2025). As required by law, Care Resource includes a clear and conspicuous link to this resource on its website and provides the link in all job vacancy advertisements and postings issued by the health center. For more information, please see the link to the new Care Provider Background Screening Clearinghouse Education and Awareness website. https:
//info.flclearinghouse.com (https://info.flclearinghouse.com) Experience Required 2 year(s): Experience in medical settings specifically referrals, authorization and medical records processing. Education Required High School or better in Other Skills Required Achievement Acknowledging Others Active Listening Analysis Checking for Accuracy Collaborating Commitment Compassion Customer Service Documentation Integrity Interpersonal Skills Microsoft Office Multitasking Planning & Organizing Problem solving Telephone Verbal Communication Written Communication Healthcare Systems Behaviors Required Enthusiastic:
Shows intense and eager enjoyment and interest Detail Oriented:
Capable of carrying out a given task with all details necessary to get the task done well Team Player:
Works well as a member of a group Motivations Required Ability to Make an Impact:
Inspired to perform well by the ability to contribute to the success of a project or the organization Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.
