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OP Rehab Representative PD

Job Description - OP Rehab Representative PD

Minimum Requirements / Work Experience

Ø  Proficient or advanced computer skills in Microsoft Word and Excel.

Ø  One to two years medical front office experience required. 

Ø  General knowledge of third party payors\: PPO, EPO, POS, HMO, and workers’ compensation

Ø  Familiarity with IPA and medical group structure and communication preferred

Ø  Familiarity with CADENCE and EPIC healthcare software preferred

Ø  Experience with insurance authorization, pre-certification, and tracking preferred

Ø  Knowledge of applicable Title 22 regulations and Joint Commission (JC) standards preferred

Ø  Bi-lingual preferred (English & Spanish or English & Vietnamese)

Ø  Positive work ethic

Ø  Excellent interpersonal skills

Ø  Strong organizational skills

Ø  Ability to communicate effectively

Ø  Strong customer service skills

 

Education / Licensure / Certification

Ø  High school graduate or GED equivalent preferred

Ø  Medical terminology preferred


Purpose Statement / Position Summary

This position requires the full understanding and active participation in fulfilling the mission of Orange Coast Memorial Medical Center. It is expected that the employee will demonstrate behavior consistent with our core values\: Accountability, Best Practices, Compassion and Synergy.   The employee shall support Orange Coast Memorial Medical Center’s strategic plan and participate in and advocate performance improvement/patient safety activities.  

 

The Front Office Receptionist is responsible for providing clerical support to the Outpatient Rehabilitation Department, which includes but is not limited to medical record management and preparation, billing and charge reconciliation, processing functional outcome questionnaires, scheduling appointments, navigating EPIC and other providers’ and entities’ software, building and managing rehabilitation personnel templates, registering patients, obtaining and modifying authorization and re-authorization for treatments, verifying benefits, tracking attendance, tracking utilization, addressing EPIC and billing audits, addressing health plan audits, processing quarterly downtime drills, coding, collecting co-pays and other fees, processing and depositing money, receiving patients, answering phones, retrieving messages, maintaining filing system, data entry, ordering supplies, coordinating medical reporting and records, opening and closing the clinic, assisting Manager, and other duties as assigned.

 

Essential Job Outcomes & Functions

Ø  Polite and proactive communication with patients, patient’s families and staff.

Ø  Proactive in maintaining inventory and ordering supplies in a timely manner.

Ø  Satisfactory completion of all department operations.

Ø  Manages time to allow for completion of all daily tasks.

Ø  Timely, efficient, and accurate registration and scheduling process.

 

Job Specific Competencies

Ø  Consistently applies infection control policies/procedures.

Ø  Meets population specific competencies

Ø  Attends department specific education/training, in-services, staff meetings

Ø  Provides input to improve department operations, equipment and supply needs.

Ø  Complies with Patient Safety Goals for Patient Identification.

Ø  Demonstrates collaborative teamwork and communication style both in-person and on the telephone to ensure optimal workflow and professional dialogue among and between staff and patients

Ø  Evaluates incoming information received (either by FAX, Rightfax, mail, courier, patient or other customers) and properly distributes or acts upon the information received in a timely and efficient manner.  When processing orders, follows up for incomplete orders, unclear orders or doctor's request to call patient.  

Ø  Effectively navigate EPIC/CADENCE including scheduling initial evaluation and follow-up appointments, auditing/reconciling charges, reviewing the medical record, templating/building provider schedules, generating the referral record, and managing PTO

Ø  Abides by department time and attendance policy

Ø  Accurately posts daily charges and identifies correct CPT codes for all interventions among all disciplines and completes billing reconciliation process on a timely manner.   

Ø  Demonstrates the ability to effectively verify benefits, register, and check-in patients and prepare and manage hard charts and their corresponding electronic medical records for up to 115 patients per day

Ø  Demonstrates the ability to effectively communicate electronically and verbally with physicians’ offices, IPAs, medical groups, and health plans to facilitate the authorization-authorization, or modification of additional physical and speech therapy treatments

Ø  Reliably collect co-pays for treatments and payments for community programs, close out the cash drawer, deposit money, process functional outcome questionnaires, and process quarterly downtime drills.

Ø  Ensures HIPAA compliance on every patient by identifying patient charts with 2 patient identifiers prior to proceeding with output of information.

Ø  Attach appropriate CPT and ICD codes to authorizations or referrals

Ø  Manage front office operations by entering requisitions for office or department supplies, opening and closing the front office, and other duties as requested

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